Cervical Cancer Risk Assessment
Cervical cancer was once one of the most common causes of cancer death among women in the United States, but today many cases of cervical cancer are prevented through widespread use of the Pap test.
Vaccines are also available to prevent infection by certain strains of human papillomavirus (HPV), a major cause of cervical cancer, as well as many other cancers.
According to the American Cancer Society (ACS), cervical cancer tends to develop in midlife. Most women are diagnosed with cervical cancer before the age of 50; about 15% are older than 65. Early cervical cancer and precancerous conditions of the cervix have no symptoms. This assessment will help you find out your relative risk for cervical cancer. This assessment is valid for women between the ages of 21 and 69 who have had sexual intercourse at least once and who have not had a hysterectomy with removal of the cervix.
Based on the information you provided, you have one or more risk factors for cervical cancer. A risk factor is any condition or behavior that increases your likelihood of developing a disease. Having a risk factor does not necessarily mean you will develop a disease. Knowing what your risk factors are helps your healthcare provider schedule appropriate screenings and recommend preventive measures. It also helps you identify things you can change to help lower your risk for cervical cancer.
For cervical cancer, the primary risk factor is infection with certain high-risk types of HPV, or human papillomavirus. Other secondary risk factors also come into play. Based on the answers to your assessment, your risk factors, if any, are listed below.
The information you provided suggests that you have none of the common risk factors for cervical cancer covered in this assessment. Your results show the following preventive factors that decrease your likelihood developing cervical cancer by varying degrees:
Primary risk factor:
- You have a health history of HPV infection. Infection with certain high-risk types of HPV is the most important risk factor for cervical cancer. Most women diagnosed with cervical cancer have this virus. See "Understanding Risk Factors for Cervical Cancer" below for more information about this risk factor.
Secondary risk factor(s):
Your results indicate you have one or more secondary risk factors for cervical cancer:
- You had sexual intercourse before age 18. Intercourse at a young age is considered a risk factor because it increases your chances of contracting HPV.
- You have had sexual intercourse with more than one partner. Sex with multiple partners is considered a risk factor because it increases your chances of contracting HPV.
- You have HIV or AIDS. HIV infection or any condition that weakens the immune system puts women more at risk of getting HPV.
- You have a health history of chlamydia.
- You have a family history of cervical cancer or cervical dysplasia. There is evidence that genetic factors are involved in the development of some cervical cancers.
- You are years old. The incidence of cervical cancer increases in midlife and goes down after age 50.
- You smoke. Cancer-causing chemicals have been found in the cervix of women who smoke.
- Your diet needs more fruits and vegetables.
Your results also indicate the following preventive factors that decrease your risk for cervical cancer by varying degrees:
- You did not have sexual intercourse before you were 18 years old. Intercourse at a young age is considered a risk factor because it increases your chances of contracting HPV.
- You have had sexual intercourse with only one partner. Sex with multiple partners is considered a risk factor for cervical cancer because it increases your chances of contracting HPV.
- You have had a Pap test within the last 2 years. Having regular Pap tests as recommended by your healthcare provider is the most important preventive measure for cervical cancer. Recommended frequencies for Pap testing vary according to each woman's circumstances. See "The Importance of Screening" below for specific guidelines.
- You don't smoke.
- You eat a healthy amount of fruits and vegetables.
Understanding risk factors for cervical cancer
The most important risk factor for cervical cancer is being infected with the human papillomavirus (HPV). Most women diagnosed with cervical cancer have this virus. HPV is passed on through skin contact with an infected part of the body, usually on or near the sexual organs. Your risk of getting this virus increases if you have sex at an early age, if you have more than one sexual partner during your lifetime, if your partner has had multiple sex partners, or if you have sex with uncircumcised males.
HPV refers to a group of more than 150 types of viruses. Some of these are low risk and cause genital warts. Only a few HPVs cause cervical cancer. In fact, about two-thirds of all cervical cancer cases are caused by only two types, HPV 16 and HPV 18. Yet most women who are infected with these types of HPV don't develop cervical cancer.
HPV infection does not always cause warts or other symptoms, so you can pass it to another person without knowing it. Although condoms protect against many sexually transmitted diseases (STDs), they don't offer total protection against HPV. This is because HPV can be passed on by skin contact with an infected area of the body that can't be covered with a condom. Even when no warts are present, HPV can stay in the skin and be passed on. A vaccine for HPV is available for people between ages 9 and 26. The vaccine is intended to be given to people before they become sexually active.
According to the American Cancer Society (ACS), other factors that increase your risk for cervical cancer are:
- HIV infection. HIV, the virus that causes AIDS, damages the body's immune system. This and any other condition that weakens the immune system puts a woman at greater risk for HPV infection, which may increase the risk for cervical cancer.
- Chlamydia. Chlamydia is a common sexually transmitted disease with few symptoms. Recent research suggests that a past or current chlamydia infection may put a woman at greater risk for cervical cancer.
- Family history of cervical cancer or cervical dysplasia. Women whose mother or sisters have had cervical cancer or cervical dysplasia are at greater risk themselves for cervical cancer. It has been suggested by some researchers that some women may not fight off HPV infection as well as others owing to an inherited condition.
- Smoking. Women who smoke are about twice as likely as nonsmokers to get cervical cancer. Tobacco smoke contains many cancer-causing chemicals that are carried throughout the body in the blood. These chemicals have been found in the cervix of women who smoke.
- Poor diet. Women who consume few fruits or vegetables may be at higher risk for cervical cancer.
The importance of screening
The increased use of the Pap test has dramatically reduced deaths from cervical cancer. Pap tests find early cancers and changes in the cells of the cervix that could lead to cancer. Cervical cancer develops slowly, usually taking years to progress from a precancerous condition to cancer. For many women, the precancerous changes will not progress to cancer or will go away without any treatment. Precancerous conditions can also be treated, however, preventing cancer from developing.
The American Cancer Society recommends that:
- All women at average risk should have Pap tests starting at age 21.
- Women between ages 21 and 29 should have a Pap test every 3 years.
- Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years.
- Women older than age 65 who have had regular screening with normal results should not be screened for cervical cancer. Once screening is stopped, it should not be started again.
- A woman who has had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious precancer should not be screened.
- A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
Tips for an accurate Pap test
To make sure your Pap test results are accurate, the ACS recommends the following:
- Don't schedule your test for a time when you are having your menstrual period. The best time is at least 5 days after your period stops.
- Don't douche within 2 days (48 hours) of your test. In general, douching is not recommended, because it disrupts the natural bacteria and acidity in the vagina. This can irritate the vagina and actually increase the risk for certain infections.
- Don't have sexual intercourse within 2 days (48 hours) of your test.
- Don't use tampons, vaginal medicines, foams, creams, or jellies within 2 days (48 hours) of your test.
Pap test, pelvic exam: The difference
A pelvic exam is not a Pap test, but both are usually done during the same office visit. The Pap test is often done first. For the Pap test, the healthcare provider inserts an instrument called a speculum into the vagina to hold it open, then gently scrapes or brushes the cervix with another instrument to remove a small number of cells. This sample is sent to the lab. The HPV test can be done at the same time as the Pap test, and it's done the same way. During a pelvic exam, a healthcare provider checks the health of a woman's uterus and ovaries by feeling them through the belly (abdomen). For the exam, the provider inserts 2 fingers into the vagina and presses to steady the uterus. The other hand pushes on the abdomen to feel the uterus and ovaries. A pelvic exam cannot find cervical cancer in its early stages or abnormal cervical cells.
This information is not intended as a substitute for professional health care. Always consult with a healthcare provider for advice concerning your health. Only your health care provider can do a thorough disease risk assessment or determine if you have cervical cancer.
References for Cervical CancerNational Cancer Institute
This assessment is not intended to replace the evaluation of a healthcare professional.