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The cervix is part of the female reproductive system – connecting the uterus to the vagina (or birth canal). Cervical cancer is an abnormal growth of cells on the cervix, or an abnormal growth of cells that began in the cervix. Cervical cancer is almost 100 percent preventable through regular, routine screening, avoidance of controllable risk factors, and vaccination against the human papillomavirus (HPV). In the United States, an estimated 12,170 cases of invasive cervical cancer were diagnosed in 2012, and over 4,200 deaths occurred as a result of cervical cancer. In Indiana, approximately 250 new cases of cervical cancer are diagnosed and 85 cervical cancer-related deaths occur each year.
HPV infection is the single greatest risk factor for cervical cancer. HPV is passed person-to-person through sexual contact. Delaying first sexual activity, limiting sexual partners, using condoms during sex, and being vaccinated can reduce the risk of contracting HPV.
The Centers for Disease Control and Prevention (CDC) recommends HPV vaccination for boys and girls ages 11-12. There are two vaccines (Cervarix and Gardasil) currently available. Both vaccines are recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the doses when they were younger. One vaccine (Gardasil) is recommended for boys aged 11 or 12 years, and for males aged 13 through 21 years of age, who did not get any or all of the three recommended doses when they were younger. In addition, the vaccine is also recommended for gay and bisexual men, and men who have compromised immune systems (including people living with HIV/AIDS) through age 26 years-old, who did not get any or all of the doses when they were younger.
Hoosier women are most often diagnosed with cervical cancer during their middle adult years. During 2011, 82 percent of cervical cancer cases occurred among Indiana women less than 65 years old, including 36 percent of cases occurring among women ages 25 to 44 and 46 percent among women ages 45 to 64.
In Indiana, during 2002-2011, African-American women, compared to white women, had a 22 percent higher cervical cancer incidence rate and a 50 percent higher mortality rate. While many factors are probably impacting this disparity, one apparent issue is that African-American women tend to be diagnosed more often after the cervical cancer is no longer localized.
In the United States, the cervical cancer death rate declined by almost 70 percent between 1955 and 1992, mainly because of the effectiveness of Pap smear screening. Pap screenings allow for early identification and treatment of abnormal cervical cells before they become cancerous. This is important, because typically, the pre-cancerous conditions do not cause pain or other symptoms and are only detected through Pap screenings.
There are two screening tests that can help prevent cervical cancer or find it early. The Pap test (or Pap smear) looks for pre-cancers, which are cell changes on the cervix that might become cervical cancer if they are not treated appropriately. The second test is an HPV test, which looks for the virus that can cause these cell changes.
The United States Preventive Services Task Force recommends screening for cervical cancer in women ages 21 to 65 with a Pap test every three years, or women ages 30 to 65 can screen every five years with a Pap test combined with an HPV test.
Updated February 2014.