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Cervical cancer screening: What you didn’t know you didn’t know

It's caused by infection, it doesn't affect only women, vaccination can prevent it, and getting checked really can save your life

In January, Israel and other countries around the world have been marking Cervical Cancer Awareness Week and promoting the need for regular testing, and greater awareness of this often preventable disease. It’s a good opportunity to help debunk some myths related to cervical cancer screening.

  1. “Cervical cancer is an act of fate, like all other tumors.”

Not true. Cervical cancer is caused by Human Papillomavirus (HPV) infection. Therefore, a regular check of the cervix (up to recently the PAP smear and now, the HPV screening), may detect the presence of pre-cancerous cells or viruses that predispose for cervical cancer and may actually prevent the cancer. In addition, there is a vaccine against HPV significantly reducing cervical cancer risk.

  1. “If that’s the case, then it’s worth getting tested every year or even every month to assure I don’t have the virus.” 

Also not true. Research shows that, after a negative test for HPV, in the absence of clinical symptoms, another test after five years is sufficient. If suspicious signs appear, irregular bleeding or bleeding after sex, you should have a check-up and your doctor may decide if you need a test within a shorter interval.

  1. “Cervical cancer is rare in Israel and therefore there’s no rush to get tested.”

Not true! According to Ministry of Health data, about 1,200 – 2,000 women are diagnosed every year with pre-malignant changes in the cervix and 180 women with cervical cancer. This may seem a relatively small number, but given the fact that this disease is preventable (through vaccination) and can be discovered early (by HPV testing), it’s actually a high and preventable number.

  1. “The virus only harms women.”

This is also false. HPV can also cause cancer in male genitalia and mouth.

  1. “Every case of the virus being identified must be treated.”

This is also not necessarily true. In fact, a significant number of the viruses disappear without treatment. Besides, a significant proportion of HPV types have a low potential to become cancerous and only a small number are high risk types. 

  1. “It’s worth delaying the vaccination as much as possible.” 

This is also an important misconception to combat. Children’s immune systems “learn” for the long-term and therefore a vaccination against HPV at a younger age creates a longer immunity memory. In addition, sometimes the start of sexual relations isn’t planned, and it is of course preferable to vaccinate prior to any possible exposure to HPV. 

  1. “The vaccine only prevents cancer.”

Not true. The vaccination significantly reduces the rate of genital warts.

  1. “But a vaccine is always scary, because of the possible side-effects.”

In medicine, there is no such thing as ‘never’. However, data for millions of vaccines has revealed only rare side effects, most of them local and transient. Ultimately, when weighing up the costs/benefits, the vaccine is extremely safe and effective. In case of doubt, for example among children who are allergic, please consult with your doctor.

  1. “If that’s the case, after the vaccine, I don’t have to use other preventative measures while having sexual relations.”

Not true! The vaccine provides high protection against HPV, but, as always, there is no such thing as 100 percent protection. In addition, it doesn’t prevent other sexually transmitted diseases and, of course, it is not a contraceptive and does not prevent unwanted pregnancies.

  1. “If a suspicious virus is detected, or a clinical complaint, I should go to a specialist in cervical examination and have a specific examination of the cervix (colposcopy).”

As of today, in the case of a clinical suspicion, the gynecologist will refer the patient for a cervical examination by a cervix expert (colposcopy). There are important developments in the field of detection, including a new technology enabling visual examination of the cervix using an innovative device developed by Israeli company Illumigyn. This system allows the identification, diagnosis and documentation of the cervix by general medical staff, and reviewed by a cervical expert. This technology will not only increase the accuracy of diagnoses but also allow women without immediate access to gynecology specialists to still get the very best care. Illumigyn’s technology is currently undergoing wide-ranging clinical trials in Israel.

  1. “So what’s the bottom line? What should I do today?”

Every woman should have a routine gynecological examination every year. At this appointment, cervical cancer screening will be performed, if indicated and if needed, an HPV vaccine will be recommended. In the event of any irregular bleeding or other abnormalities, a gynecological examination should be carried out earlier than within a year. And of course, as ever, we advise correct and responsible sexual behavior and advocate for the need to educate the next generation to do the same.

About the Author
Dr. Israel Yoles is a senior gynecologist and head of Gynecological services at the Central District of Clalit Health Services.