Cervical cancer is commonly caused by human papillomavirus (HPV). Despite being preventable with proper screening, this disease is the 4th most common cancer in women; in 2018, about 570,000 women have been diagnosed and about 311,000 have died, worldwide[1].
This widespread prevalence is due to the many misconceptions regarding the disease. Thus, January was designated as Cervical Cancer Awareness Month, to increase awareness about cervical cancer, including screening and testing, prevention, and treatment.
Here are some common myths, debunked:
MYTH: Cervical cancer cannot be prevented.
FACT: There is a highly effective vaccine available to prevent most high-risk HPV infections; combined with regular screening tests (Pap smear and hrHPV testing), cervical cancer can easily be prevented.
MYTH: If you have HPV, you will get cervical cancer.
FACT: HPV isn’t the sole cause of cervical cancer; there are many other risk factors, such as smoking, Chlamydia infection, and HIV infections[2]. Also, getting an HPV infection does not automatically mean you will get cervical cancer- there are more than 100 strains of the HPV virus, of which persistent infections with high-risk types can damage cells, causing cancer[3].
MYTH: Getting the vaccine is enough to prevent the disease, there is no need for screening.
FACT: Even if you received the HPV vaccine, you still need to be screened routinely; according to Dr. Douglas Owens, Vice Chair of The U.S. Preventive Services Task Force, most cases of cervical cancer that occur now are in women who haven’t been regularly screened or appropriately treated[3].
MYTH: Only women with multiple sexual partners are prone to the disease.
FACT: A common misconception, cervical cancer can develop even in women with only one sexual partner.
MYTH: Lesbians and women who have sex with women (WSW) are not at risk for the disease.
FACT: This is another common misconception; HPV is transmissible via skin-to-skin genital contact, as well as through oral-vaginal and digital-vaginal contact. Therefore, women who exclusively have sex with women are at risk for HPV and cervical cancer[4].
MYTH: Transgender men cannot get cervical cancer,
FACT: Transgender men who have not had their cervix removed are still at risk for cervical cancer, and should be screened[4].
MYTH: One must get a Pap smear every year.
FACT: Annual screening is not recommended, as screening too often can result in more false-positives which can cause undue stress/anxiety and unnecessary follow-up procedures[5]. Rather, the new guidelines recommend:
● For women aged 21-29, a Pap smear every 3 years.
● For women aged 35-69, a Pap smear every three years, HPV testing every five years, or a combination of Pap smear and HPV testing every five years.
MYTH: Cervical cancer screening tests for all cancers.
FACT: Cervical cancer screening does not test for all gynaecological cancers, such as ovarian cancer and fallopian cancer; they only screen for cervical cancer[5].
MYTH: A woman cannot have a baby if she has cervical cancer.
FACT: While cervical cancer treatment does include hysterectomy, chemotherapy, and radiation therapy to the pelvic area, there are a lot of new treatment options that enable the doctor to spare patients’ fertility. Doctors can use assisted reproductive technologies to freeze eggs, and they can surgically move the ovaries out of the radiation field to save them from any harm[6].
The cervix is an important part of the female anatomy, playing an essential role in a woman’s sexual and reproductive health. However, the misconception about cervical screening being for “promiscuous women”, and the numerous disparities in LGBTQ+ healthcare, have served as barriers to the testing process, leading to numerous fatalities.
As future doctors, we must do our part to raise awareness and ensure that all women receive this vital health service.
As the adage goes: “Prevention is better than cure”.
REFERENCES:
1. Arbyn M, Weiderpass E, Bruni L, Sanjosé S, Saraiya M, Ferlay J. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis [Internet]. The Lancet. 2019 [cited 5 February 2021]. Available from: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30482-6/fulltext
2. HPV & Cervical Cancer Myths vs. Facts | Mount Sinai – New York [Internet]. Mount Sinai Health System. 2021 [cited 6 February 2021]. Available from: https://www.mountsinai.org/care/cancer/services/gynecologic/conditions/cervical/myths-facts 3. Kee C. Updated Cervical Cancer Screening Guidelines Include More Options For Women [Internet]. Buzzfeednews.com. 2021 [cited 6 February 2021]. Available from: https://www.buzzfeednews.com/article/carolinekee/new-cervical-cancer-screening-guidelines
4. [Internet]. Lgbtqiahealtheducation.org. 2021 [cited 6 February 2021]. Available from: https://www.lgbtqiahealtheducation.org/wp-content/uploads/Promoting_Cervical_Cancer_Screening_LBWomen.pdf
5. Facts & Myths [Internet]. Bccancer.bc.ca. 2021 [cited 6 February 2021]. Available from: http://www.bccancer.bc.ca/screening/cervix/cervix-health/facts-myths
6. Grade Definitions | United States Preventive Services Taskforce [Internet]. Uspreventiveservicestaskforce.org. 2021 [cited 6 February 2021]. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/grade-definitions
7. 8 Cervical Cancer Myths and Facts You Need to Know – Cytecare [Internet]. Cytecare Hospital in Bangalore. 2021 [cited 6 February 2021]. Available from: https://cytecare.com/blog/8-myths-about-cervical-cancer/
Author’s Data
Name: Anjali Mediboina
University: Alluri Sita Ramaraju Academy of Medical Sciences
AMSA India