Risk, Prevention & Screening
More than 90 percent of cervical cancers today are caused by infection with the human papillomavirus (HPV), a virus so common that more than two-thirds of sexually active women are infected with it at some point.
In part because cervical cancer tends to grow so slowly, there are a number of measures that a woman can take to prevent it from spreading and becoming advanced.
In addition to infection with the HPV virus, factors that increase the risk for cervical cancer include:
- Having first sexual intercourse at an early age
- Having many sexual partners
- Giving birth to three or more children
- Smoking cigarettes (this produces chemicals that can damage cervical cells)
- Using oral contraceptives
- Being infected with the human immunodeficiency virus (HIV), the virus that causes AIDS (HIV reduces the body’s ability to fight off HPV infection and early cancers)
Women without HPV infection or any of these other risk factors rarely develop cervical cancer.
Measures to Prevent Cervical Cancer
To protect against cervical cancer, you can get regular Pap smears to screen for any changes in the cells of the cervix.
To protect yourself from getting HPV, use condoms regularly. Other than the presence of genital warts, there is no way of knowing whether a sexual partner is infected with HPV. While condoms do not provide complete protection – HPV can spread through physical contact with infected areas of the mouth, genitalia, and anus – the American Cancer Society reports that using condoms can reduce the rate of HPV infection by about 70 percent. Using condoms regularly also protects against various other sexually transmitted diseases.
You can also discuss HPV vaccination with your doctor. There are several strains of HPV, some of which are more likely than others to cause cancerous cell changes in the cervix. The first vaccine approved by the US Food and Drug Administration was Gardasil®. The vaccine specifically targets HPV types 16 and 18, which cause about 70 percent of cervical cancer cases, and types 6 and 11, which cause approximately 90 percent of cases of genital warts. The vaccine can only be used to prevent an HPV infection; it is not meant for women who already are infected.
Additional studies are under way to identify vaccines that target other types of HPV linked to cervical cancer, help the immune systems of men and women already infected with HPV to destroy the virus, and aid women with advanced or recurrent cervical cancer.
If you are interested in learning more about these vaccines, ask your Memorial Sloan Kettering team for information.
Schedule Regular Cervical Cancer Screenings
Memorial Sloan Kettering’s screening and surveillance guidelines for cervical cancer emphasize that Pap smear and other tests are effective methods of screening for cervical cancer, revealing the presence of HPV and early cancerous changes in the cells of the cervix.
We recommend that women have their first cervical cancer screening at 21 years of age, regardless of age at first sexual intercourse.
We recommend cervical cytology testing every two years, either through a Pap smear or a slightly more advanced approach that provides better samples for review, called liquid-based cytology. In this approach, pathologists review cervical cells that have been processed in a liquid and placed on slides.
We recommend one of the following three screening strategies:
- Cervical cytology testing (which can include Pap smears or liquid-based cytology, a way of preparing the cells for examination) every two years.
- For women who have had three negative or satisfactory annual cytology tests, we recommend screening with cytology every three years.
- For women whose cytology and DNA tests are negative, we recommend cytology plus an HPV-DNA test every three years. The HPV-DNA test is performed to see whether HPV is present. If it is not, there is no infection and less chance of developing cervical cancer — and therefore the time between screenings can be increased.
We recommend annual screening (with Pap smear or liquid-based cytology) for women of any age whose immune system is compromised or weakened for any reason, such as following organ transplantation, HIV infection, or cancer chemotherapy. We also recommend annual screening for women who were exposed to DES (a nonsteroidal synthetic estrogen drug) while in utero.
For more detailed information about screening, see our screening guidelines for cervical cancer.