UC HEALTH LINE: Safe Sex, Screening Can Reduce Cervical Cancer Risk

Public awareness has decreased the number of women who suffer from cervical cancer, but according to a UC gynecological oncologist, even more women can avoid the disease by practicing safe sex and making early detection a priority. “Infection is a chief risk factor associated with cervical cancer, and most infections are transmitted sexually,” explains Nader Husseinzadeh, MD, a professor of obstetrics and gynecology. “The other major contributing factor is avoidance of preventive screening tests. About 65 percent of women diagnosed with cervical cancer haven’t followed the recommended screening guidelines.”

The cervix is a narrow opening at the bottom of the uterus (womb) that connects the organ to the vagina.  Cervical cancer occurs when abnormal cells in the area begin growing uncontrollably.

Dr. Husseinzadeh says that cervical cancer can often be linked to intercourse before age 18 and “high-risk” behaviors at a young age, which include unprotected sex (without condoms) and multiple partners. People who smoke and who have immunosuppressive diseases are also at higher risk.

“Since birth control pills were introduced, I’ve seen young women’s attitudes change toward sex,” explains Dr. Husseinzadeh. “Birth control pills protect against pregnancy—but they don’t protect against dangerous sexually transmitted diseases, like chlamydia, gonorrhea, HIV and other infections.”

According to the National Cancer Institute, the human papillomavirus (HPV) is the most common sexually transmitted infection. HPV is a family of more than 100 viruses that can cause abnormal tissue growth. Certain types of HPV may increase a woman’s risk of developing cervical cancer.

“Cervical cancer grows slowly, so it’s important to detect significant cellular differences early—before the abnormal cells change into cancer,” says Dr. Husseinzadeh. “With proper treatment, we can treat almost 100 percent of lesions before they become cancerous.”

He notes that each year in the United States alone, more than 3 million women are diagnosed with cervical abnormalities.

“However,” Dr. Husseinzadeh continues, “even if the abnormal cells have already developed into early-stage cancer, cervical cancer is still one of the most treatable types of cancer.”

The American Cancer Society estimates that more than 10,370 women were diagnosed with cancer in 2005. The disease, which is most common in women over 40, will also result in about 3,700 deaths. Patients who have early-stage invasive cervical cancer have a five-year survival rate of between 85 and 92 percent. For advanced-stage cancer, the survival rate is less than 10 percent.

Dr. Husseinzadeh and his colleagues recommend the following steps for prevention and early detection of cervical cancer:

Practice responsible, safe sex.

Women who have sexual intercourse before age 18, who do not use barrier contraceptives and who have had more than three sexual partners are at greater risk for developing an HPV infection and cervical cancer.

Dr. Husseinzadeh cautions that birth control pills and spermicidal gels may offer some protection, but they do not completely protect against sexually transmitted diseases. To be safe, he recommends using a diaphragm in conjunction with the pill.

Make early detection a priority.

Whether or not they are sexually active, all women under age 65 should have an annual pelvic exam and Papanicolaou test—commonly known as a Pap test. The physician collects a small sample of cells from the surface of the cervix, which are then examined under a microscope for suspicious changes.

If the physician detects precancerous cell changes—known as dysplasia—he’ll recommend further testing, which may include a colposcopy, a procedure that uses a microscope to examine the inside of the cervix, and a tissue biopsy. Most precancerous changes are found in women who have had regular Pap tests.

Kick the smoking habit.

According to the U.S. Preventive Services Task Force, cigarette smoking has been consistently correlated with cervical cell abnormalities and cancer, at minimum doubling—and in some cases quadrupling—a woman’s risk for the disease.

Ceasing to smoke also will improve your overall health, since the habit has been linked to heart disease, lung cancer and vascular problems. 

Patients with early-stage cervical cancer typically have no symptoms. If symptoms do appear, the cancer has probably spread to other parts of the body. First signs of disease may include spotting or bleeding—often following intercourse—and foul-smelling discharge. The individual may also experience abdominal pain, problems while urinating or defecating and swelling of the legs.

“Any of these symptoms can also be caused by noncancerous gynecologic problems,” warns Dr. Husseinzadeh, “so it’s important to consult your physician when they occur.” 

UC is part of the Center for Disease Control and Prevention’s National Breast and Cervical Cancer Screening Project, an effort to educate and provide cancer screenings to un- or underinsured low-income women. The UC team has provided free Pap tests to nearly 6,000 women since 2002.

Dr. Husseinzadeh, principal investigator on more than 30 gynecological oncology clinical trials at UC, is a member of the Gynecologic Oncology Group, a national, nonprofit cancer research team sponsored by the National Cancer Institute. He is also one of nearly 140 UC experts answering health-related questions from consumers on NetWellness, a collaborative, health-information Web site staffed by Ohio physicians, nurses and allied health professionals. For more information, visit

www.netwellness.org

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