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Description
An in-depth report on the causes, diagnosis, treatment, and prevention of cervical cancer.
Alternative Names
Dysplasia; Human papillomas virus; Pap smear
Prevention
The best way to prevent cervical cancer is to avoid getting infected with human papilloma virus (HPV). Because HPV is sexually transmitted, practicing safe sex and limiting the number of sexual partners can help reduce risk. A vaccine is now available that can protect against some cancer-causing HPV strains. Regular Pap tests remain the most effective way of preventing the development of invasive cervical cancer.
Vaccines against HPV
Several cervical vaccines are now in development. These vaccines target HPV 16 and HPV 18, the most dangerous strains of human papilloma virus. HPV 16 and 18 cause 70% of cervical cancers.
In 2006, the FDA approved the first vaccine to prevent cervical cancer. Gardasil has been tested in over 12,000 uninfected women in 13 countries. Studies show it provides nearly 100% protection against HPV 16 and 18. Gardasil also protects against HPV 6 and HPV 11, which cause genital warts. The vaccine is approved for girls and women ages 9 – 26. Because the vaccine cannot protect females who are already infected with HPV, doctors recommend that girls get vaccinated before they become sexually active. Research presented at the 2006 American Society of Clinical Oncology meeting suggested that the vaccine may also help prevent vaginal and vulvar cancers.
Another type of cervical cancer vaccine (Cervarix) is also being investigated. It protects against HPV 16 and 18, as well as the cancer-causing strains HPV 31, 45, 52. It does not protect against genital warts.
Gardasil is given as 3 injections over a 6-month period. The FDA is not yet sure how long the vaccine’s protection lasts or when patients may require a booster shot. A 2006 study of the Cervarix vaccine found that protection lasted for at least 4.5 years.
These vaccines do not protect against all types of cancer-causing HPV. The FDA still recommends that women receive annual screening to detect any early signs of cervical cancer.
Use of Barrier Contraceptives
Use of barrier contraceptives such as condoms is associated with a reduced risk of cervical cancer, even in women already infected with human papilloma virus. HPV can exist outside the area protected by the male condom, so this method is not foolproof in preventing an initial infection. However, a 2006 New England Journal of Medicine study found that when men used condoms every time they had sexual intercourse, their female partners had less than half the rate of HPV infection as women whose partners used condoms less than 5% of the time. The female condom is becoming increasingly popular in developing countries. It may prove to be particularly effective against sexually transmitted diseases in these regions.
Male Circumcision
A 2002 study reported that men who are circumcised have a lower risk for carrying HPV and therefore reduce the risk for cervical cancer in their female partners.
Vitamins
Some studies have suggested possible protective benefits against cervical cancer from certain vitamins.
- High blood levels of vitamins E and C have been linked with lower rates of some cancers, including cervical cancers.
Although vitamin E is a fat-soluble vitamin, there are no known toxic effects of megadoses.
- Folic acid, a B vitamin, prevents birth defects and may also lower the risk for development of dysplasia (precancerous changes) leading to cervical cancer. It is not clear how strong this association is, or why this would occur. Some evidence points to its actions in reducing levels of homocysteine, a compound associated with a higher risk of cervical cancer.
There is no definitive evidence, however, that taking vitamins can prevent any cancer. Eating healthy foods rich in such vitamins and other important nutrients is, in any case, the best approach for overall good health.
- Review Date: 9/1/2006
- Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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