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Guide to Care for patients: HPV & cervical cancer

Whaf s cervical cancer?

Cervical cancer happens when a harmful growth occurs on the surface of the cervix at the entrance to the uterus. Most times, cervical cancer develops slowly when precancerous changes occur in these cells. Routine screening tests can often detect these changes. When cervical cancer is detected and treated early, it's almost 100% curable.

What's HPV?

Human papillomavirus (HPV) causes nearly all cases of cervical cancer. Many types of HPV can be transmitted during sexual activity.

HPV infection doesn't usually cause symptoms, but some people develop genital warts. These soft, moist, pink or red warts can be raised or flat or small or Large. They may appear aLone or in clusters. Genital warts may appear within weeks or months after sexual contact with an infected person.

A pregnant woman can pass HPV infection to her baby during vaginal delivery (although this doesn't often happen). A baby exposed to HPV during delivery may develop warts on the larynx (voice box).

How does my health care provider check for cervical cancer?

Most women with cervical cancer are diagnosed with a Pap test (aLso called a Pap smear). During this test, your health care provider will insert a device called a speculum into your vagina to widen the opening. Shell then take a sample of cells from the cervix with a plastic spatula and small brush and send the cells to a lab, where they will be looked at under a microscope.

The Pap test is very good, but it has some drawbacks. For example, its accuracy depends on the experience and judgment of the person Looking at the cells. She may have trouble telling the difference between abnormal and healthy cells in some samples. And some cells that look abnormal may never develop into cervical cancer.

With newer Pap tests, the cells are placed in a special liquid to improve the accuracy of the reading. But this method may be more costly, and you may be expected to cover the added cost yourself.

What if I have an abnormal Pap test?

If you have suspicious Pap test results, your health care provider will collect another cervical cell sample for HPV testing. (The HPV test isn't routinely recommended for women younger than age 30 because many women in this age-group test positive for HPV that eventually clears up on its own.) Your health care provider may also recommend you have a speculoscopy, which involves using a special light to view your cervix. The PapSure test is a type of speculoscopy.

To do the PapSure test, your health care provider takes a sample for a Pap test, then swabs your cervix with a special solution. She waits about 60 seconds for the solution to take effect and then examines your cervix with a magnification device. Because of the special solution, abnormal areas have a different color than normal areas.

How often should I be tested?

According to the latest American Cancer Society guidelines, you should follow this advice:

* Have your first Pap test by age 21 or within 3 years of your first sexual intercourse, whichever is first.

* Continue to have a Pap test every year or a Liquid-based Pap test every 2 or 3 years.

* If you've had three normal test results in a row after age 30, you may be tested every 2 or 3 years, rather than every year. Your health care provider may suggest that you be tested more often if you have certain risk factors, such as human immunodeficiency virus (HIV) infection or a weakened immune system.

* If you're older than 30, you may receive a combination of HPV testing with a Pap test. If the results of both tests are normal, you can be screened with both tests no more frequently than every 3 years. If only one test result is normal, you should keep having yearly screening.

You don't need to be tested routinely if you're age 70 or older and have had three or more normal Pap test results in a row and no abnormal results in the last 10 years. If you've had a total hysterectomy, which removes the cervix, you can also skip routine testing, unless the surgery was done as a treatment for cervical cancer or precancer.

If you've had a hysterectomy without removal of the cervix, you should continue cervical cancer screening until you're at least age 70.

How is an HPV infection treated?

Although an HPV infection can't be cured with medicine or other treatments, it may eventually clear up on its own. But a few women have an infection that doesn't go away, increasing the risk for cervical cancer.

If you have genital warts, your health care provider k may treat them with topical medicine applied to the skin. Or, she may remove them surgically or with cryotherapy (freezing).

Keep in mind that removing warts doesn't necessarily mean the HPV infection is gone. You may still be able to transmit HPV to a sexual partner. How long you'll remain infected with HPV after you get treatment for genital warts isn't known.