How to decrease your risk for cervical cancer

Are you getting appropriate cervical cancer screening? Dr. Judith Reichman explains simple tests that can aid prevention

Last year, 10,000 women in the United States were diagnosed with cervical cancer and almost 4,000 died from this largely preventable disease. "Today" medical contributor Dr. Judith Reichman was invited onto the show to help you make sure you are getting appropriate cervical cancer screening.

A bipartisan association called Women in Government just announced that in some states women are not getting appropriate cervical cancer screenings. Best grades for screening were given to Delaware, Massachusetts, Illinois, Maryland and North Carolina. The worst grades went to Tennessee and Texas.

Let's do a quick review: What causes cervical cancer? Is it really a sexually transmitted disease?
Yes. We know that 99.7 percent of cervical cancers are caused by sexually transmitted viruses called the human patillomavirus, or HPV. There are more than 30 types of genital HPV viruses. Those classified as high-risk HPVs are more likely to result in cervical cancer abnormalities or high-grade lesions (HSIL) that lead to cervical cancer. Low-risk HPVs usually result in cervical changes that are less likely to be precancerous - such as low-grade lesions, or LSIL - although they cause venereal warts in about 1 percent of those infected.

HPV is very contagious during intercourse, and unfortunately, condoms won't completely protect you; the virus can spread through skin-to-skin contact. As a result, HPV is found in more than 70 percent of sexually active young adults! And because there are virtually no symptoms, most people are unaware that they have it.

Fortunately, most HPV infections do not lead to a pre-cancer or cancer of the cervix. Most infections are temporary, especially in younger women, and cervical cancer in women under the age of 19 is rare. In adolescence and young adulthood, 70 percent of high-risk HPV types and 90 percent of low-risk HPVs weaken or disappear after three years.

If a persistent high-risk HPV infection does enter the cervical cells, the process can take three years before the infection takes over and causes cell mutations. This means that if we wait three years from the onset of intercourse (when a woman can become infected) to begin cervical cancer screening, it is unlikely that we will fail to detect any cervical cancers.

How does a woman know she has an HPV infection? Should she routinely be checked for this type of virus?
I have to emphasize that lack of symptoms does NOT mean that a woman (or her partner) is virus-free. In sexually active younger women, there is a good chance that an HPV viral test will indeed be positive.

On a personal note, I can tell you from clinical experience that receiving a diagnosis of high-risk HPV can produce a feeling of overwhelming anxiety in the patient and her loved ones, as well as in the treating physician. Questions such as: "When did I get this? Who gave it to me? Does this mean that I can give it to all my future partners? Will it affect my babies?" are common and can't be answered with any certainty, although transmission during pregnancy is highly unlikely.