The Latest Recommendations on Cervical Cancer Screening and HPV Vaccination
Why is my doctor recommending an HPV test?
HPV or the human papillomavirus is the single known cause for cervical cancer. It is a common virus that usually goes away on its own. If the virus does not clear, persistent HPV can lead to pre-cancerous and cancerous changes. These changes can be easily treated preventing invasive cancer.
It is only in the past few decades that HPV testing has become available for use in clinical practice. Now providers are able to test not only for HPV, but also for the specific types of high-risk HPV related to cancer. If you are screened and don’t have these types of HPV we can be reassured that you are not at risk for developing cancer. We don’t have to check again for 5 years if you are over age 30 and free from any HIV infection or any exposure to DES.
What are the recommendations for cervical cancer screening in the United States?
The following central organizations provide recommendations about cervical cancer screening:
- The American Society for Colposcopy and Cervical Pathology (ASCCP)
- American College of Obstetricians and Gynecologists (ACOG)
- U.S. Preventive Services Task Force (USPSTF)
These organizations have come to an agreement about cervical cancer screening recommendations:
- Women under 21 should not be screened
- Women 21-30 should receive pap cytology screening every 3 years
- Women over 30 should get co-testing with cytology and HPV testing every 5 years, but cytology every 3 years is acceptable with reflex HPV testing
- Women over 65 do not need to be screened as long as they are not at high risk for cervical cancer
Do I need cervical cancer screening if I don’t have sex?
If you have ever had sex in your life, you have potentially been exposed to the HPV virus and need to be screened. Any contact in the ano-genital region (including oral, manual, penile) can lead to HPV transmission. It is a common virus.
Do I need cervical cancer screening if I’ve already had a hysterectomy?
If you have had a hysterectomy other than for cervical cancer or pre-cancer, you do not need cervical screening. However, if your hysterectomy was related to cervical cancer or pre-cancer, your doctor may recommend sampling of the vaginal or vulvar tissue.
What about the HPV vaccine?
The HPV vaccine is a highly effective way to prevent invasive cervical cancer as well as cancers of the head and neck and genital warts. There is NO evidence that these vaccines lead to autism or other neurologic disorders.
Who should receive the HPV vaccine?
The target age for the HPV vaccine is 11-12, however, the Centers for Disease Control and Prevention (CDC) and the American College of Obstetrics and Gynecology recommend routine HPV vaccination for females and males aged 9–26 years.
What about the new HPV vaccine?
The most recent of the HPV vaccines cover seven of the HPV types associated with cervical cancer, which provides protection for 70-90% of potential cancers. It also protects against the most common HPV types that cause 90% of genital warts.
- You don’t need to be re-vaccinated if you already completed the previous series of 3 Gardisil.
- If you only received one dose of the previous series, you can receive the newer 9-valent HPV vaccine for your 2nd dose.
- If you are under age 15 you only need 2 doses of Gardisil 9.
The HPV vaccine is a cancer vaccine!
Vaccines, by reducing viral infection can actually reduce cancer risk. The Hepatitis B vaccine reduces liver cancer, which worldwide is the most common cancer.
The HPV vaccine reduces cervical cancers as well as anal and throat cancer. The HPV virus does NOT cause premature ovarian insufficiency.
What should I do if I have HPV?
- You need regular GYN exams.
- More frequent paps smears.
- You may need an office colposcopy, a diagnostic test. The pap smear is only a screening test.
- You need to ingest a healthy diet.
- Stop smoking.
- You may want to consider the supplement DIM.
What is DIM?
Diindolylmethane (DIM) and its precursor Indole-3-carbinol (I-C-3) are naturally occurring compounds found in cruciferous vegetables such as:
- brussel sprouts
These chemicals are currently being studied at the National Cancer Institute as treatment options for a variety of viral and bacterial infections as well as cancer and pre-cancerous conditions. Regarding women's health, the use of cruciferous vegetable indoles may have importance for control of cervical dysplasia and breast cancer prevention. DIM is still under study, but it is always a good idea to ingest fruits and vegetables in your diet as they have anti-cancer benefits.
DIM is also available as a dietary supplement. You can find it online and in health food stores. The recommended daily dose is 200mg. DIM and I-C-3 is fat soluble, so it needs to be taken with an oil-based supplement to maximize its absorption. Oil-based supplements include:
- Vitamin E
- Flaxseed oil
- Fish oil
Be Strong. Be Healthy. Be in Charge!
-Miriam Cremer, MD and Lynn Simpson, MD
NOTE: Dr. Cremer receives honoraria from the vaccine manufacturer Merck for speaking work.
Lynn Simpson, MD is a retired physician from the Center for Specialized Women's Health at Cleveland Clinic. Dr. Simpson was a physician at Cleveland Clinic from 2010 - 2021.
She earned her medical degree from The Ohio State University College of Medicine and Public Health. Dr. Simpson completed her residency in OB/GYN at Grant/Riverside Methodist Hospitals in Columbus, Ohio. She has numerous publications in Obstetrics and Gynecology.
- Cervical Cancer Screening Guidelines
- New USPSTF Draft Recommendation on Cervical Cancer Screening
- Update on HPV Vaccine Recommendations
- Cervical Cancer & HPV
- Gynecologic Cancers: Paying Attention to Suspicious Symptoms