Gynecologic Oncology

Putting an End to Cervical Cancer

Pui "Joan" Cheng, M.D
Putting an End to Cervical Cancer

New vaccines and screening options may ease the burden for many women. Cervical cancer was once one of the deadliest cancers for women in the United States. Throughout the decades, rates of cervical cancer have steadily declined by more than half because more and more women are getting regular Pap tests, which detect abnormal cells in the cervix. However, in the past 15 years, according to the American Cancer Society, rates have not changed much. In the U.S., about 12,000 women are diagnosed with cervical cancer—and more than 4,000 women die from it—each year. Two new preventive tools in the fight against cervical cancer may help the numbers of deaths and diagnoses slide further toward zero.

Common Sexually Transmitted Virus

Almost all cervical cancers are caused by the human papillomavirus (HPV). HPV is the most common sexually transmitted virus in the U.S. More than 80 percent of women and 90 percent of men who are sexually active will have at least one type of HPV at some point in their lives.

Most women who become infected with HPV are able to fight off the virus on their own. But some women develop long-term infections from HPV, which can lead to cervical cancer. It often takes 10 years or longer for the infection to lead to cancer.

FDA-Approved Vaccines

There are three FDA-approved vaccines that can prevent HPV infections. According to the Centers for Disease Control and prevention, the vaccines (Gardasil, Gardasil 9 and Cervarix) are safe and effective. All three are proven to be highly effective in preventing cervical cancer from two types of high-risk HPV, HPV 16 and 18. Gardasil and Gardasil 9 also help prevent genital warts caused by HPV.

The U.S. government recommends that all girls and boys ages 11-12 get the vaccine in two doses at least six months apart. After age 14, a three-dose series of the vaccine, given over six months, is recommended for young women through age 26 and young men through age 21 who have not been previously vaccinated. The vaccine causes no serious side effects. Pregnant women should wait until after their pregnancy to receive the vaccine.

HPV Test Checks Out

The vaccine does not replace regular Pap tests and pelvic exams, which screen for cervical cancer. That’s because the vaccines don’t guard against all of the HPV types that cause cancer or other non-HPV related problems.

HPV testing is available, which identifies high-risk HPV subtypes that may develop into cancer. A new study sought to determine whether the HPV test or the “Pap” test (liquid based cytology) was more effective at detecting and preventing cervical precancers. The results, published in the Journal of American Medication Association, could mean major changes for the future of cervical cancer screening.

Detecting More Precancers

For the study, more than 19,000 women were divided into two groups. One group received the HPV test and the other, the “Pap” test. Researchers detected significantly more cases of cervical precancers among women in the HPV test group than those who received a Pap.

What’s more, women who received the HPV test at the start of the study were much less likely to develop cervical precancer four years later compared with those who were screened with the Pap test. This suggests that HPV testing may detect precancerous cells earlier and more accurately than the Pap test.

The Best Prevention

Screening is the most important step you can take to prevent cervical cancer. If you have abnormal cells, your doctor can remove them before they have a chance to develop into cancer.

FIND A TOURO DOC

Talk with your doctor about the screening and vaccination schedules that are best for you. If you need help finding a physician, Touro can help connect you with one. Just call 504-897-7777 or visit touro.com/findadoc today.

Cheng, Joan

Dr. Joan Cheng was born in Hong Kong and came to the U.S. at a young age, where she grew up in South Carolina. She attended Duke University to earn her B.S. in Biology. She then moved to New Orleans to pursue her M.D. at Tulane University School of Medicine. She left New Orleans for several years to complete her residency in Obstetrics and Gynecology at State University of New York at Stony Brook and then moved across the country to pursue her Fellowship in Gynecologic Oncology at University of Southern California in Los Angeles.

Dr. Cheng, who served as a faculty member at Tulane Medical School before joining Touro’s Crescent City Physicians group in 2007, treats gynecologic cancers such as endometrial, cervical, ovarian and vulva cancers, as well as other complex gynecologic issues that require specialized surgical skills, including robotic surgery.