Questions & Answers
1. Will women still need to get Pap tests once they have been vaccinated against cervical cancer? If so, how often?
Gardasil, the HPV vaccine, provides protection against only four of the sub-types of HPV. Therefore, women should continue to have regular Pap tests every one to three years depending on their individual medical history. Women should speak with their health provider to determine the appropriate interval between Pap tests for them.
2. Why is the death rate for cervical cancer higher in blacks than whites?
There are likely multiple contributing factors. Overall, there is a higher incidence (number of new cases) of cervical cancer among black women. Long intervals between Pap tests can decrease the likelihood of detecting cancer at an early stage, which would decrease the probability of successful treatment. Inadequate follow-up of abnormal Pap tests can also delay the diagnosis and successful treatment of cervical cancer. It is important for all women to have regular Pap tests and to follow up on abnormal results.
3. Should women be tested for HPV in addition to receiving Pap tests?
HPV testing in women who get an unclear (borderline) Pap test result is helpful in directing next steps in cervical cancer screening. For women over 30, this test can also be used with the Pap test as part of routine cervical cancer screening. This test is approved only for use as part of cervical cancer screening. It is important for women to talk with their health care provider to see if getting the HPV test along with the Pap test is right for them.
4. Do condoms protect against HPV?
Condoms may lower the chances of developing HPV-related diseases (genital warts and cervical cancer) if used all of the time and in the right way. But HPV can infect areas that are not covered by a condom — so condoms may not fully protect against HPV.
5. Once a woman has completed her three vaccinations against cervical cancer, will booster shots be required?
The length of vaccine protection (immunity) is usually not known when a vaccine is first introduced. So far, studies have followed women for five years and found that women are still protected. More research is being done to find out how long protection will last, and if a booster vaccine is needed years later.
6. Why is smoking associated with cervical cancer?
Several studies have associated smoking with a higher risk for abnormal changes in the cervix and for progression to cervical cancer. It is not clear if this association is due to effects on the immune system or direct cancer-causing effects by cigarette smoke. One study detected cancer-causing substances from tobacco in cervical cells of women who smoke.
7. Why is chlamydia, a sexually transmitted disease, a risk factor for cervical cancer?
Studies are finding an especially strong association between the incidence of chlamydia trachomatis, a sexually transmitted infection (STI), and HPV. The presence of an STI can be a marker of high sexual activity, which is an important risk factor for cervical cancer.
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Lisa Michelle Owens, M.D.
Medical Director
Brigham Primary Physicians at
Faulkner Hospital
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