Overview of Prevention

Prevention Purposes of this summary

Cervical Cancer Prevention

Significance of cervical cancer Cervical cancer prevention

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Changes to This Summary (09/21/2007)
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Overview of Prevention

Prevention

Doctors cannot always explain why one person gets cancer and another doesn’t. However, scientists have studied general patterns of cancer in the population to learn what things around us and what things we do in our lives may increase our chance of developing cancer.

Anything that increases a person’s chance of developing a disease is called a risk factor; anything that decreases a person’s chance of developing a disease is called a protective factor. Some of the risk factors for cancer can be avoided, but many cannot. For example, although you can choose to quit smoking, you cannot choose which genes you have inherited from your parents. Both smoking and inheriting specific genes could be considered risk factors for certain kinds of cancer, but only smoking can be avoided. Prevention means avoiding the risk factors and increasing the protective factors that can be controlled so that the chance of developing cancer decreases.

Although many risk factors can be avoided, it is important to keep in mind that avoiding risk factors does not guarantee that you will not get cancer. Also, most people with a particular risk factor for cancer do not actually get the disease. Some people are more sensitive than others are to factors that can cause cancer. Talk to your doctor about methods of preventing cancer that might be effective for you.

The purposes of this summary on cervical cancer prevention are to

• Give information on cervical cancer and how often it occurs.
• Describe cervical cancer prevention methods.
• Give current facts about which people or groups of people would most likely be helped by following cervical cancer prevention methods.

You can talk to your doctor or health care professional about cancer prevention methods and whether they would be likely to help you.

Cervical Cancer Prevention

The uterine cervix is the lower, narrow part of the uterus (womb) that connects the uterus with the vagina. It is part of the female reproductive system.

Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.

Thanks to widespread screening with the Pap test (Pap smear), the number of deaths due to cervical cancer has been decreasing. Screening tests have risks, however (refer to the PDQ summary on Screening for Cervical Cancer ¹); prevention of cervical cancer may offer fewer risks and more benefits.

Many cases of cervical cancer are associated with known risk factors for the disease. Some of the risk factors cannot be avoided, but many can.

HPV Infection: Cervical infection with HPV is the primary risk factor for cervical cancer. There are over 80 types of human papillomavirus (HPV). Approximately 30 types are transmitted sexually (passed from one person to another by sexual contact) and can infect the cervix. About half of these have been linked to cervical cancer. However, HPV infection is very common and only a very small number of women infected with untreated HPV will develop cervical cancer. A vaccine to prevent infection with the two types of HPV that cause approximately 70 percent of cervical cancers, and the two types of HPV that cause 90 percent of genital warts, has been approved by the U.S. Food and Drug Administration (FDA), and other vaccines are under study. The approved vaccine provides protection against infection with these HPV types for at least five years. How much longer the protection lasts is under study.

Sexual History: HPV infections that cause cervical cancer are spread mainly through sexual contact. Women who begin having sexual intercourse at an early age and women who have had many sexual partners are at a greater risk of HPV infection and developing cervical cancer. Some methods used to prevent sexually transmitted diseases (STDs) reduce the risk of cervical cancer. The use of barrier methods of birth control and/or gels that kill sperm offer some protection but do not completely protect against STDs.

Reproductive History: Having a high number of full-term pregnancies (7 or more) increases the risk of cervical cancer.

Use of Oral Contraceptives: Long-term use of oral contraceptives (5 years or more) increases the risk of cervical cancer.

Screening History: Receiving regular gynecological exams and Pap tests helps to prevent cervical cancer. Abnormal changes in the cervix can be detected (found) by the Pap test and treated before cancer develops. Women who do not regularly have Pap tests have an increased risk of cervical cancer.

Smoking: Cigarette smoking is associated with an increased risk of cervical cancer.

Diet: Several studies have suggested that certain micronutrients (vitamins and minerals) may reduce the risk of cervical cancer, but this has not been proven.

Knowing the risk factors for cervical cancer can help you avoid them.

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Changes to This Summary (09/21/2007)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary.

Questions or Comments About This Summary

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About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ³. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether a certain drug or nutrient can prevent cancer. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients and those who are at risk for cancer. During prevention clinical trials, information is collected about the effects of a new prevention method and how well it works. If a clinical trial shows that a new method is better than one currently being used, the new method may become "standard." People who are at high risk for a certain type of cancer may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ⁶. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Glossary Terms

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope).

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

Cells that look abnormal under a microscope but are not cancer.

FDA. An agency in the U.S. federal government whose mission is to protect public health by making sure that food, cosmetics, and nutritional supplements are safe to use and truthfully labeled. The Food and Drug Administration also makes sure that drugs, medical devices, and equipment are safe and effective, and that blood for transfusions and transplant tissue are safe. Also called FDA.

The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.

A raised growth on the surface of the genitals caused by human papillomavirus (HPV) infection. The HPV in genital warts is very contagious and can be spread by skin-to-skin contact, usually during oral, anal, or genital sex with an infected partner. Also called condyloma.

Having to do with the female reproductive tract (including the cervix, endometrium, fallopian tubes, ovaries, uterus, and vagina).

A member of a family of viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells. Infection with certain types of HPV increases the risk of developing cervical cancer. Also called human papillomavirus.

A member of a family of viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells. Infection with certain types of human papillomavirus increases the risk of developing cervical cancer. Also called HPV.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

Transmitted through genes that have been passed from parents to their offspring (children).

A nutrient required to maintain health.

A pill used to prevent pregnancy. It contains hormones that block the release of eggs from the ovaries. Most oral contraceptives include estrogen and progestin. Also called birth control pill.

A procedure in which cells are scraped from the cervix for examination under a microscope. It is used to detect cancer and changes that may lead to cancer. A Pap test can also show noncancerous conditions, such as infection or inflammation. Also called a Pap smear.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Used to prevent disease.

Something that may decrease the chance of getting a certain disease. Some examples of protective factors for cancer are getting regular physical activity, staying at a healthy weight, and having a healthy diet.

The organs involved in producing offspring. In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). In men, it includes the prostate, the testes, and the penis.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

Checking for disease when there are no symptoms. Since screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (breast), colonoscopy (colon), Pap smear (cervix), and PSA blood level and digital rectal exam (prostate). Screening can also include checking for a person’s risk of developing an inherited disease by doing a genetic test.

The male reproductive cell, formed in the testicle. A sperm unites with an egg to form an embryo.

A group or layer of cells that work together to perform a specific function.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the womb.

A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. A vaccine can help the body recognize and destroy cancer cells or microorganisms.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.

A key nutrient that the body needs in small amounts to grow and stay strong. Examples are vitamins A, C, and E.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called the uterus.