Adrian Ziaggi is a 2nd year family medicine resident at WHS. She is from Western NY, and attended Oberlin College for her undergradute degree. She then graduated from medical school at the University at Buffalo. She started her residency training in 2020.
Cervical cancer is the most common cancer in adult women of developing countries.
In the US it is 18th in incidence and mortality, likely thanks to our prevention and screening. There are an estimated 13,800 new cases and 4,300 deaths of cervical cancer in the US annually. HPV is the cause of cervical cancer, and is very common. In fact, 80% of patients will be infected with HPV at some point in their life.
Cervical cancer prevention in our patients is achieved via two main strategies, one of which is the Gardasil vaccine. This vaccine prevents against nine different strains of HPV, most importantly the highest risk strains (16 and 18) which are more likely to cause cancer. Gardasil protects against cervical cancer, but also several other types of cancer as well (including oral, throat, and anal cancers), and should be administered to all patients starting at age 11. However, if you are an adult who did not get this vaccine as a child, it has recently been approved for patients up to age 45! So talk to your doctor and get vaccinated today.
The other strategy to protect our patients against cervical cancer is to the screening, called Pap smear, which allows us to periodically check the cells of the cervix to make sure they look normal. At the same time, we can also check for the presence of HPV. Most HPV infections will resolve on their own, as the body’s immune system fights them off. We can help our immune systems fight HPV by getting the Gardasil vaccine! If the body is not able to fight off the HPV infection, this is when we are more likely to see precancerous changes on the pap smear. The longer the HPV infection persists, the more likely it is to progress to cervical cancer over time. Smoking will also make it more difficult for the immune system to clear an HPV infection. Some pap smear changes are minor, and only require increased surveillance, such as a repeat pap smear in 1 year instead of a repeat in 3-5 years. However, sometimes we need to do a procedure called a colposcopy. A colposcopy allows us to use a special scope which magnifies the cervix and helps identify any abnormalities. We can then biopsy areas that look concerning, and send them to pathology for a tissue diagnosis.
Preventive medicine is our best defense against all kinds of cancer, cervical included. Start the new year right by going to see your doctor, and make sure you are up to date on your vaccines and screening tests!