1. Cervical Cancer and Vaccines
Imelda De Vera Guimary, APN
Division of Gynecologic Oncology
University Hospital

2. The Cervix
It is the lower, narrow end of the uterus (or womb)

3. Cervical Cancer
Each year, approximately 12,000 women in the US get cervical cancer
Among the leading causes of death worldwide
Used to be the leading cause of cancer death in the US
In the past 40 years, there has been a major decrease in the number of deaths from cervical cancer DUE TO…

4. PAP tests!
One of the most reliable and effective screening tests available
All women should start getting regular Pap tests at age 21
Cervical cancer is the only gynecologic cancer with an effective screening test
The Pap test ONLY screens for cervical cancer

5. Pap Tests (cont’d) Who should get it and how often?
Women between the ages of should get a Pap test every 3 years
Women should get a HPV test with a Pap test every 5 year
IF you are 65+, ask your doctor
If you had a hysterectomy, you no longer need to get them
The HPV test looks for HPV, and can be used with the Pap test (co-testing)

6. Types of Pap tests
Conventional Pap = samples collected from the cervix using a speculum and then smeared onto a slide directly
Best to be used when not menstruating
Liquid based cytology = uses an arrow-shaped brush rather than a speculum to obtain a sample of cells and then suspended in a bottle of preservatives while transported to the library
Can be done while woman is menstruating

7. Who get cervical cancer?
Occurs most often in women over the age of 30
All women with a cervix are at risk
Women who have had a total hysterectomy are not at risk

8. What can cause or increase the risk of getting cervical cancer?
Human papillomavirus (HPV) – a sexually transmitted infection (STI)
Smoking
Having HIV
Using birth control pills for a long time
Having given birth to three or more children

9. What are the signs and symptoms?
Vaginal bleeding (especially after sex)
Abnormal discharge from the vagina

10. HPV Vaccines There are two types of HPV vaccines: What do they do?
Gardasil (Merck)
Cervarix (GSK)
What do they do?
They prevent cervical, vaginal, and vulvar cancers
Taken in 3 doses

11. Who should get the HPV vaccines?
Recommended for:
11 and 12 year old girls
Females between the ages of years who have never received any of the shots when they were younger
Also for boys and young men

12. Vaginal and Vulvar cancers
Imelda De Vera Guimary, APN
Division of Gynecologic Oncology
University Hostpial

13. The Vagina and Vulva Vagina = the birth canal
Vulva = outer part of the female genitals (the labia)

14. Who gets vaginal and vulvar cancers?
Approximately 1,000 women in the US every year (vaginal)
Approximately 3,500 women in the US every year (vulvar)
Rarer types but still a sizeable portion

15. What causes or increases the risk of getting vaginal OR vulvar cancer?
Many similarities with cervical cancer:
HPV
Smoking
HIV
Some different:
Being aged 50 or older (vulvar)
Exposure before birth (while in the womb) to Diethystilbestrol (DES), a man-made form of estrogen

16. Signs and symptoms of Vaginal
Abnormal vaginal discharge or bleeding
Bleeding may be:
Heavy or long
Occurring outside of menstruation or between periods
Occurring after menopause
Pain in pelvis or abdomen, especially when urinating or having sex

17. Signs and Symptoms of Vulvar
Itching, burning, bleeding on vulva
Color changes or rashes, warts, sores on skin of vulva
Pain in pelvis, especially when urinating or having sex

18. KEY POINTS
Cervical cancer is the only gynecologic cancer with an effective screening test (Pap)
The Pap test ONLY screens for cervical cancer
HPV vaccines can help prevent cervical, vaginal, and vulvar cancers
Smoking and HPV can increase the risk of getting these cancers
Call your doctor after experiencing any of the warning signs and symptoms for two weeks or longer