Transcription:
Cervical Cancer Screening

Amanda Wilde (Host): When cervical cancer is found early, it's usually highly treatable. So today, we'll look into screening and who's at risk with Sabrina Meddaugh, family nurse practitioner at Cumberland Healthcare.

Welcome to Healthier You from Cumberland Healthcare. I'm Amanda Wilde. Sabrina, thank you so much for being here to share your expertise.

Sabrina Meddaugh: Thank you for having me.

Amanda Wilde (Host): I have so many questions for you. But first, what causes cervical cancer?

Sabrina Meddaugh: Cervical cancer is caused by a virus called HPV, which someone may be exposed to via either oral or sexual contact. The HPV virus itself has multiple strains, although the strains 16 and 18 are responsible for most HPV related cancers. In addition to cervical cancer, HPV is also capable of causing cancer among the penis, anus and also the back of the throat. So, those are also areas to think about as well.

Amanda Wilde (Host): So when we're talking screening, should we include men as well as women?

Sabrina Meddaugh: Today in particular, we're talking more about women in terms of the cervix and screening of the cervix. But HPV is also something that can be screened among men in regards to the area of back of the throat and the penis and anus as well. Correct.

Amanda Wilde (Host): Is cervical cancer in any way hereditary or a predisposition to getting it hereditary at all, genetic at all? Or is this purely exposure to a virus that can happen to anyone?

Sabrina Meddaugh: Yes. So, cervical cancer is not genetic. There is no hereditary component to cervical cancer itself. It's solely caused by exposure to the HPV virus.

Amanda Wilde (Host): So, who is at high risk for developing cervical cancer? That would be the person who is at high risk for being exposed to that virus. What are some common ways, you said oral and sexual contact, that people are exposed to HPV? Is there a way to prevent exposure?

Sabrina Meddaugh: Yes. So, those at highest risk in developing cervical cancer in particular are individuals who have unprotected sexual contact with multiple partners. So, the key here is individuals with multiple sexual partners places you at a higher risk in developing cervical cancer itself. There are ways to prevent cervical cancer. One way is in obtaining the HPV vaccine. That actually has the potential to prevent more than 90% of HPV-attributed cancers. So, since the HPV vaccine was first recommended in about 2006, infections with HPV types that cause most cervical cancers and genital warts has dropped by 88% alone among teen girls, and 81% among young adult women, according to the CDC. So, the HPV vaccine really does have really good evidence behind the prevention of cervical cancer.

Amanda Wilde (Host): So if you get the vaccine, you are unlikely to get HPV and therefore unlikely to get cervical cancer. But how do you make sure? How are you screened for cervical cancer?

Sabrina Meddaugh: Cervical cancer, of course, was once the most common cause of cancer death among women. But this has drastically been reduced, just given increased screenings with pelvic exams and Pap tests. So, a Pap test is completed via a pelvic exam, which looks for pre-cancerous or cells that are changing in the cervix itself that may cause cervical cancer down the line, if not caught early and treated appropriately.

In addition to the Pap or pelvic exam, we also test for the HPV virus, of course, that causes those cells to change and that can cause that to create cervical cancer.

Amanda Wilde (Host): What are the symptoms of cervical cancer that could come up in a screening?

Sabrina Meddaugh: So, symptoms of cervical cancer in individual patients are very vague. Some people have no symptoms. Some people have very vague symptoms, which could include abnormal vaginal bleeding, abnormal vaginal discharge, pelvic discomfort, bloating. And because the symptoms are so vague, that's why it is so important to obtain your preventative screenings in order to catch the cancer at an early stage to provide overall a better outcome long term.

Amanda Wilde (Host): So, screenings are something you should do periodically. How early in life should you start with cervical cancer screening?

Sabrina Meddaugh: Cervical cancer screening is recommended for women beginning at age 21, regardless of prior sexual contact. We recommended this at age 21 because young adults may be positive prior to age 21 with the HPV virus. But many young adults are able to heal from the virus without causing cancer cells or without cancer cells developing. So, the recommended age to begin screening is 21.

Amanda Wilde (Host): And at what age is the the HPV vaccine recommended?

Sabrina Meddaugh: The HPV vaccine is recommended starting at age 11 to 12. The first dose is given typically between these ages, but can be given as early as age nine.

Amanda Wilde (Host): I was going to ask if there's an age limit. So, it might start at nine and then, do you have to re-up your vaccine periodically?

Sabrina Meddaugh: The first dose is typically given between ages 11 and 12, again can be given as early as age nine. The second dose is then given around six to 12 months following the first dose. It's typically a two-dose series. If the vaccine is given after someone's 15th birthday, three doses may be needed just to better build their immunity over a six-month timeframe at that point.

There is an age limit, per se, to the vaccine. We typically recommend a vaccine before age 26, and this is because most adults have already been exposed to the HPV virus by this time. The vaccine although still may be given after age 26 with a discussion between the patient and their healthcare provider, if they feel that they still may benefit from the vaccine beyond age 26.

Amanda Wilde (Host): Are there any side effects from the HPV vaccine?

Sabrina Meddaugh: The HPV vaccine itself has been monitored now for over the past 15 plus years and has been proven to be very safe and effective. Of course, all vaccines are monitored to ensure safety and it will continue to be monitored to ensure safety in regards to that. Possible side effects of course in obtaining the HPV vaccine, and really any vaccine alone could include pain, redness, swallowing at the injection site, could also include some nausea, headache, or fainting following the injection itself.

Amanda Wilde (Host): And this is all of course to prevent cervical cancer, that's why we're getting the vaccine. How common is cervical of cancer? You mentioned earlier that the incidence in the US has gone way, way down since the vaccine. Is it rather rare now to have cervical cancer?

Sabrina Meddaugh: Correct. So, the incidence has decreased just with the addition of the HPV vaccine, in addition to women becoming screened more frequently. So, every year in the United States, according to the CDC currently, there still are nearly 200,000 women diagnosed with cancer pre-cells. And around 11,000 of those women are diagnosed and treated for cervical cancer caused specifically by the HPV virus. And over 4,000 women approximately in the United States alone die from cervical cancer. So, those numbers are actually quite low when you're looking at the United States as a whole.

Amanda Wilde (Host): We talked about the HPV vaccine and how that works in terms of a timetable. How often should the cervical cancer screening be completed? And is there an age limit on that?

Sabrina Meddaugh: So, you can lower your risk, of course, of cervical cancer by obtaining the screening regularly starting at age 21 with that pelvic and Pap smear. Intervals of screening include every three years, beginning at age 21 through age 30, and then we increase that screening interval to every five years once you're age 30 between age 65. We also complete HPV testing during those times as well.

Amanda Wilde (Host): Why is it more common for younger people to get HPV and therefore have higher risk of cervical cancer?

Sabrina Meddaugh: The precursor to HPV is that sexual contact. And so, younger individuals that are exploring different relationships tend to be at just a little bit of a higher risk because they have multiple partners or may have multiple partners, putting them at a little bit higher risk in obtaining the HPV virus itself, which then of course can put them at precursor for developing cervical cancer.

Amanda Wilde (Host): Now, January is Cervical Cancer Awareness Month in the US. Sabrina, what is the best way to raise awareness?

Sabrina Meddaugh: It is Cervical Cancer Awareness Month, and so it's really important to talk with your healthcare provider about cervical cancer screening if you have never been screened in terms of when you should be screened and the interval of screening for you based on age in order to reduce the risk of developing cervical cancer yourself. And if you do have precursor cancer cells, in order to have the appropriate treatment, in order to continue to be monitored appropriately, and then in order to improve your outcomes as you move forward in your healthcare journey.

Amanda Wilde (Host): So, talking to your healthcare provider is all part of that prevention and screening, along with getting those HPV vaccinations. It's just really heartening to know that this is a highly treatable and preventable cancer as long as it's caught early, and these are the ways we can deal with that. Thank you so much, Sabrina, for your expertise and this great information.

Sabrina Meddaugh: Yes. Thank you.

Amanda Wilde (Host): For more information, call 715-822-7500. Check out our website at cumberlandhealthcare.com. This is Healthier You, a podcast from Cumberland Healthcare. Thanks for listening and be well.