Cervical cancer is a type of cancer that develops in the cervix, the lower part of the uterus that connects to the vagina. It arises when cells in the cervix grow abnormally and form a tumor. While it can affect individuals of various ages, there is a clear relationship between age and its incidence.
Understanding Age and Risk
Cervical cancer is most commonly diagnosed in individuals between the ages of 35 and 44, though it rarely occurs in those younger than 20. However, over 15% of cases are found in individuals over 65, indicating that risk persists into older age. The primary cause of cervical cancer is persistent infection with high-risk types of Human Papillomavirus (HPV), a common sexually transmitted infection.
Younger individuals often encounter HPV through sexual activity, with early sexual debut increasing exposure risk. The cervix undergoes changes during puberty, potentially making it more susceptible to HPV infection and subsequent cellular changes. While most HPV infections in young people clear spontaneously within two years, persistent infections can lead to precancerous lesions over time. Older individuals remain at risk due to long-term persistent HPV infections or changes in immune response that allow dormant infections to become active. Other risk factors, such as a weakened immune system, multiple full-term pregnancies, or prolonged use of oral contraceptives, can also contribute to cervical cancer development.
Screening Guidelines
Cervical cancer screening effectively detects precancerous cell changes before they develop into cancer, or finds cancer at an early, more treatable stage. Screening typically involves a Pap test, which looks for abnormal cervical cells, or an HPV test, which detects high-risk HPV infections. These tests can be used together in a co-test.
Generally, individuals with a cervix should begin screening at age 25. A primary HPV test every five years is the preferred method for those aged 25 to 65. If a primary HPV test is not available, a co-test combining an HPV test and a Pap test every five years, or a Pap test alone every three years, are acceptable alternatives. Regular screening is important, even for those who have been vaccinated against HPV, as the vaccine does not protect against all HPV types that can cause cervical cancer. Screening can be discontinued after age 65 with adequate prior normal results and no history of serious precancerous diagnoses within the past 25 years. However, individuals with a history of precancer or a weakened immune system may need to continue screening beyond age 65, following their healthcare provider’s advice.
Prevention Strategies
The HPV vaccine is a primary prevention strategy for cervical cancer, protecting against the types of HPV that cause most cases. The vaccine is most effective when administered before an individual becomes sexually active and potentially exposed to HPV. Routine HPV vaccination is recommended for children at age 11 or 12, though it can be started as early as age 9.
For individuals who were not vaccinated within the routine age recommendations, catch-up vaccination is recommended through age 26. Adults aged 27 through 45 may also consider HPV vaccination after discussing it with their clinician, though benefits may be less significant as many in this age range have already been exposed to HPV. The vaccine works by preventing new HPV infections, reducing the risk of developing precancerous lesions and cervical cancer. Beyond vaccination, other general preventive measures include practicing safe sexual behaviors to reduce HPV exposure and avoiding smoking, as smoking can increase the risk of cervical cancer.