Prevention

Cervical cancer is preventable. Early detection of abnormal cell changes is important. Almost all women and men will have HPV at some point, but very few women will develop cervical cancer. The immune system of most women will usually suppress or eliminate HPV. Only HPV infection that does not go away over many years can lead to cervical cancer, for example.

Being vaccinated before exposure to the virus helps protect women against cervical cancer and the precancerous lesions that precede it. Regular Pap tests will help detect any precancerous or abnormal cells early enough so that cervical cancer can be prevented. Together vaccination and screening can save more lives and suffering.

For those who choose to be sexually active, condoms may lower the risk of HPV. One study found that when condoms are used correctly every time sex occurs, they can lower the HPV infection rate by about 70%. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV.

Women may also want to consider minimizing risk factors that could contribute to cervical cancer. Those factors include:

  • Smoking
  • Multiple sexual partners
  • Sexual intercourse at an early age
  • Chlamydia infection
  • Weakened immune system or HIV infection


Screening

Early detection is key in preventing cervical cancer. The traditional way women are checked for cervical cancer is with a Pap test, which can find changes in the cells of the cervix that are not normal.

Recently updated guidelines have changed things a bit: it is now recommended that all females begin having Pap tests at age 21, regardless of when they become sexually active. Also, the familiar "yearly Pap" is no longer recommended, as new research indicates women with normal test results can safely have Pap tests once every three years.

In women 30 and over, screening using both an HPV test and a Pap test is the recommended approach. If both tests are negative (normal), a woman may safely have her next Pap and HPV test in five years depending on her past Pap test findings and other risk factors. For this reason, some women now may have an HPV test when they have their Pap test. It will still be important to continue having routine recommended preventative health exams.

Recently one HPV test—the cobas® test—was approved for use with women age 25 and older for primary cervical cancer screening (meaning it can be done alone without a Pap test). With HPV primary testing, women who test positive for high risk HPV will than have a Pap test, while those positive for the more aggressive HPV 16 and HPV 18 will be referred for colposcopy (where a health care provider uses a special lighted microscope to examine a woman’s cervix directly).

It’s also acceptable to continue screening women with Pap tests alone. The most common abnormal Pap result is called ASC-US, or atypical squamous cells of undetermined significance. About half of the women with ASC-US have these cell changes because of the presence of HPV, while the other half do not. Women with ASC-US Pap tests often have a follow-up HPV test: if the HPV test is negative, you probably will continue with normal, routine screening. Usually only women with ASC-US who test positive for HPV need further evaluation. HPV testing is helpful at any age for determining which women with ASC-US need follow-up.

For more, visit our page on cervical cancer screening tests.

Talk to Your Healthcare Provider

  • Ask your healthcare provider about cervical cancer and which tests you need. Experts recommend women being having Pap tests at age 21. 
  • Also ask about testing for sexually transmitted infections (STIs). All sexually active women under age 26 should be tested annually for chlamydia, for example. 

Even though screening for cervical cancer can occur less often, it is still important for you to see your healthcare provider annually for other female-related health care needs - ask your provider what he or she recommends.

HPV Vaccines

HPV vaccines can help prevent infection from both high risk HPV types that can lead to cervical cancer and low risk types that cause genital warts. There are currently three HPV vaccines available.

  • Gardasil® is vaccine available for both males and females. Developed by Merck, Gardasil® is close to 100% effective at preventing infection associated with HPV types 6 and 11(types associated with 90% of all genital warts) and types 16 and 18 (types associated with 70% of all cervical cancers, and many anal, vulvar and vaginal cancers).
  • Cervarix®, developed by GlaxoSmithKline (GSK) is a vaccine just for women. This vaccine is also close to 100% effective at preventing infection associated with HPV 16 and 18 (associated with 70% of all cervical cancers). Studies suggest Cervarix® also offers cross-protection against other “high risk” HPV types.
  • Gardasil 9® was approved in December 2014. The new vaccine covers nine HPV types: the two low-risk types that cause most cases of genital warts (HPV 6 and HPV 11) along with seven high-risk types (HPV 16, 18, 31, 33, 45, 52, and 58) found in a number of cancers, including about 90% of cervical cancers around the world as well as most anal, vulvar, and vaginal cancers.

Experts recommend that all females between the ages of 9 and 26 get an HPV vaccine. About half of all new infections are diagnosed in girls and young women between 15 and 24 years of age, so early vaccination is important. Males are at risk for HPV and related diseases, too, so boys and young men are also recommended to be vaccinated.

Tested in thousands of people in many countries, both vaccines have proven to be safe and well tolerated; the most common side effect has been soreness at the injection site.

While vaccination rates among girls and young women are still low (as of 2010, only 49% of girls between the ages of 13 and 17 had received at least one dose of the vaccine, and only 32% completed all three doses), rates of infection with strains of HPV covered by the vaccines have dropped significantly. Researchers comparing HPV infections rates among females ages 14-19 in years before (2003-2006) and after (2007-2010) the first HPV vaccine became available found a 56% drop in infection rates for the HPV types covered by the vaccine.

Designed primary for parents, the video below offers answers to some common questions about the HPV vaccine.



Common Questions about HPV Vaccines

Do I need all 3 shots?
Yes! You may not be fully protected if you don’t receive all three shots.

Will the vaccine help my HPV go away faster?
No, the vaccines do not treat HPV or related diseases.

Why should my son get the vaccine? I thought it was only for girls.
Males are at risk for HPV, too. HPV vaccination can protect boys against genital warts and anal cancer.

My children are not yet sexually active, do they need the vaccine?
The vaccine is most effective before the onset of sexual activity.  The CDC recommends vaccinating girls / boys at 11-12 years old.

My children are older than 11 or 12. Is it too late to get the vaccine?
Vaccination is recommended males and females through age 26.  

If I get the vaccine I won’t have to worry about HPV anymore, right?
HPV vaccines will not eliminate all HPV or cervical cancer. The vaccines prevent the HPV types that cause 70% of cervical cancer cases. But there are other types of HPV (not covered in the vaccine) that could cause disease.

If someone is sexually active can they still get the vaccine?
Those who are already sexually active may have been exposed to one of the types of HPV that the vaccines protect against. There is still benefit though in that is unlikely that they have been exposed to all types covered by the vaccines.

How safe is the vaccine?
The safety of both HPV vaccines was studied in clinical trials before they were licensed. For Gardasil, over 29,000 males and females participated in these trials. Cervarix was studied in over 30,0000 females participating in several clinical trials performed all over the world.

What are the most common side effects?

  • Soreness where you got the shot. 
  • Redness and soreness and some pain where the shot is given.
  • About 1 person in 10 will get a mild fever. 
  • About 1 person in 30 will get itching where they got the shot.
  • About 1 person in 60 will experience a moderate fever. 

These symptoms do not last long and go away on their own.

How can I pay for the vaccine?
Most insurance companies will cover the cost of vaccination. If your does not, or if you are uninsured, there are programs that can help. The Vaccines for Children (VFC) Program is a federal program that offers vaccines at no cost for eligible children, ages 18 and under, through VFC-enrolled doctors. GlaxoSmithKline offers an assistance program for their vaccine Cervarix®, providing free vaccination for eligible uninsured women ages 19-25 who are too old for the VFC program. Merckand Co., Inc. also offers a Patient Assistance Program to help uninsured patients ages 19 and older pay for Merck's Gardasil® vaccine. Other alternatives include finding a local Planned Parenthood clinic or local health department to ask about options for reduced cost or sliding scale programs.

IMPORTANT! Women need a regular Pap test, even if they have received the HPV/cervical cancer vaccine.  Even if a woman has had the HPV/cervical cancer vaccine, she will continue to require her regular cervical cancer screen by the Pap test and HPV test when recommended. The vaccines don’t protect against all types of HPV that can cause cancer. Early detection saves lives.