Cervical Cancer and VaccinesIMELDA DE VERA GUIMARY, APN

DIVISION OF GYNECOLOGIC ONCOLOGY

UNIVERSITY HOSPITAL

The Cervix

It is the lower, narrow end of the uterus (or womb)

Cervical Cancer

Each year, approximately 12,000 women in the US get cervical cancer

Among the leading causes of death worldwide

Used to be the leading cause of cancer death in the US

In the past 40 years, there has been a major decrease in the number of deaths from cervical cancer DUE TO…

PAP tests!

One of the most reliable and effective screening tests available

All women should start getting regular Pap tests at age 21

Cervical cancer is the only gynecologic cancer with an effective screening test

The Pap test ONLY screens for cervical cancer

Pap Tests (cont’d)

Who should get it and how often?

Women between the ages of 21-29 should get a Pap test every 3 years

Women 30-65 should get a HPV test with a Pap test every 5 year

IF you are 65+, ask your doctor

If you had a hysterectomy, you no longer need to get them

The HPV test looks for HPV, and can be used with the Pap test (co-testing)

Types of Pap tests

Conventional Pap = samples collected from the cervix using a speculum and then smeared onto a slide directly

Best to be used when not menstruating

Liquid based cytology = uses an arrow-shaped brush rather than a speculum to obtain a sample of cells and then suspended in a bottle of preservatives while transported to the library

Can be done while woman is menstruating

Who get cervical cancer?

Occurs most often in women over the age of 30

All women with a cervix are at risk

Women who have had a total hysterectomy are not at risk

What can cause or increase the risk of getting cervical cancer?

Human papillomavirus (HPV) – a sexually transmitted infection (STI)

Smoking

Having HIV

Using birth control pills for a long time

Having given birth to three or more children

What are the signs and symptoms?

Vaginal bleeding (especially after sex)

Abnormal discharge from the vagina

HPV Vaccines

There are two types of HPV vaccines:

Gardasil (Merck)

Cervarix (GSK)

What do they do?

They prevent cervical, vaginal, and vulvar cancers

Taken in 3 doses

Who should get the HPV vaccines?

Recommended for:

11 and 12 year old girls

Females between the ages of 13-26 years who have never received any of the shots when they were younger

Also for boys and young men

Vaginal and Vulvar cancersIMELDA DE VERA GUIMARY, APN

DIVISION OF GYNECOLOGIC ONCOLOGY

UNIVERSITY HOSTPIAL

The Vagina and Vulva

Vagina = the birth canal

Vulva = outer part of the female genitals (the labia)

Who gets vaginal and vulvar cancers?

Approximately 1,000 women in the US every year (vaginal)

Approximately 3,500 women in the US every year (vulvar)

Rarer types but still a sizeable portion

What causes or increases the risk of getting vaginal OR vulvar cancer?

Many similarities with cervical cancer:

HPV

Smoking

HIV

Some different:

Being aged 50 or older (vulvar)

Exposure before birth (while in the womb) to Diethystilbestrol (DES), a man-made form of estrogen

Signs and symptoms of Vaginal

Abnormal vaginal discharge or bleeding

Bleeding may be:

Heavy or long

Occurring outside of menstruation or between periods

Occurring after menopause

Pain in pelvis or abdomen, especially when urinating or having sex

Signs and Symptoms of Vulvar

Itching, burning, bleeding on vulva

Color changes or rashes, warts, sores on skin of vulva

Pain in pelvis, especially when urinating or having sex

KEY POINTS

Cervical cancer is the only gynecologic cancer with an effective screening test (Pap)

The Pap test ONLY screens for cervical cancer

HPV vaccines can help prevent cervical, vaginal, and vulvar cancers

Smoking and HPV can increase the risk of getting these cancers

Call your doctor after experiencing any of the warning signs and symptoms for two weeks or longer