Understanding Cervical Cancer
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Understanding Cervical Cancer (posted January 22, 2025)

By Adam Behnke, BCPH Communications Specialist

January is Cervical Cancer Awareness Month, a time when advocates amplify their voices to raise awareness about cervical cancer prevention efforts. Each year in the United States, about 11,500 new cases of cervical cancer are diagnosed and about 4,000 women die of this cancer. In both the U.S. and across the globe, cervical cancer is most often found in women living in poverty and who lack access to health care. In today’s edition of the Healthy Herald, we’ll explore basic facts about cervical cancer, the importance of screening and early detection, how prevention is key through vaccination, and the resources available right now in Wisconsin.

What is Cervical Cancer?
Cervical cancer is a disease in which the cells in the cervix grow out of control. The cervix connects the birth canal to the upper part of the uterus, which is where a baby grows during pregnancy. Anyone who has a cervix is at risk for cervical cancer. It happens most often in people over the age of 30 and is mainly caused by certain types of the human papillomavirus (HPV). The virus is passed from one person to another during sex. HPV is common and, in fact, at least half of sexually active people will have HPV at some point in their lives. Fortunately, few will end up developing cervical cancer.

The Importance of Screening and Early Detection
Screening tests and the HPV vaccine can help prevent cervical cancer. The Centers for Disease Control and Prevention (CDC) says when cervical cancer is found early, it is highly treatable and associated with long survival and high quality of life. It remains one of the most preventable cancers today. The National Cervical Cancer Coalition (NCCC) reports that most cases of cervical cancer can be prevented through early detection and treatment of abnormal cell changes that occur in the cervix years before cervical cancer develops.

The Role of Pap Smears and HPV Testing
The traditional test for early detection has been the Pap test. For women aged 30 and over, an HPV test is also recommended. HPV tests can find any of the high-risk types of human papillomavirus that are commonly found in cervical cancer.
  • Women should start screening with the Pap test at age 21.
  • If you are 30 years old or older, screening options include:
    • A Pap test every three years
    • A Pap test and HPV test every five years
    • An HPV test every five years
Depending on the results of the tests, your doctor or health care provider may recommend additional screening or procedures, so some women may be screened more often.

The NCCC says women who have had adequate prior screening and are not otherwise at high risk can stop screening after age 65. Additionally, women who have had a hysterectomy (with removal of the cervix) also do not need to be screened, unless they have a have a history of a high-grade precancerous lesions.

The HPV Vaccine
The HPV vaccine works with screening and early detection to prevent cervical cancer. The CDC recommends all boys and girls get the HPV vaccine at age 11 or 12. The vaccine produces a stronger immune response when taken during preteen years. Women and men can also get the vaccine up to age 45 but will most likely require an additional dose of the vaccine compared to pre-teens.

Researchers comparing HPV infections rates among females ages 14-19 in years before and after the first HPV vaccine became available found a 56% drop in infection rates. Those rates continue to drop as more young people receive the vaccine.

The NCCC also points to a study out of Scotland which found no cases of invasive cervical cancer in young women who had gotten the HPV vaccine by the time they were 14. The study also found that women vaccinated between the ages of 14 and 22 had lower rates of cervical cancer than unvaccinated women.

Myths and Misconceptions
Vaccine hesitancy has been a global problem exacerbated by the COVID-19 pandemic. There are various reasons why someone might avoid receiving a beneficial vaccine, but an increasingly prevalent reason is rising mis- and disinformation online. There are several myths and misconceptions about the HPV vaccine that you might hear, but none are backed by data-driven science:

MYTH: HPV vaccines are too new to have safety and efficacy data on long-term side effects.
FACT: 15 years of real-life experience with several hundred million doses distributed worldwide.
Vaccine safety has been confirmed by WHO, CDC, and many other authorities.

MYTH: Children are not sexually active so there is no need to vaccinate them early.
FACT: The earlier you vaccinate, the better the immune response.
Fewer doses are needed when individuals are vaccinated under the age of 15 years.
The earlier you vaccinate, the better the strength of the prevention.

MYTH: Boys and men do not get cervical cancer, so they do not need a vaccine.
FACT: HPV is linked to at least five malignancies other than cervical cancer: vulvar, vaginal, anal, penile, and oropharyngeal cancers.

MYTH: HPV vaccination increases risky sexual behavior and promiscuity.
FACT: There is no evidence that HPV vaccination increases promiscuity or promotes risky sexual behavior. 

Cervical Cancer in Wisconsin
2021 is the latest year for which incidence data is available from the CDC. That year, there were 169 cases of cervical cancer reported. The rate of cervical cancer was 5.7 out of every 100,000 women. That was slightly less than the national rate, which was reported at 7 new cervical cancer cases reported for every 100,000 women.

Once diagnosed, a person can be treated in several ways. It depends on the kind of cervical cancer and how far it has spread.

Cancer treatment may include:
  • Surgery: An operation in which doctors cut out the cancer.
  • Chemotherapy: Use of special medicines to shrink or kill the cancer. The drugs can be pills you take, or medicines given in your veins, or sometimes both.
  • Radiation therapy: Use of high-energy rays (like x-rays) to kill the cancer.
  • Immunotherapy: Works with your body's immune system to help it fight cancer cells or to control side effects from other cancer treatments.
  • Targeted therapy: Use of drugs to block the growth and spread of cancer cells. The drugs can be pills you take, or medicines given in your veins. You will get tests to see if targeted therapy is right for your cancer type before this treatment is used.
If your doctor says that you have cervical cancer, they will likely refer you to a gynecologic oncologist—a doctor who has been trained to treat gynecologic cancers, including cervical cancer. This new doctor will work with you to create a treatment plan.

Local Resources and Support
As noted at the start of the article, lack of access to health care is linked to higher incidence of cervical cancer.
The Wisconsin Well Woman Program helps women who have little or no health insurance get screening for breast and cervical cancers.
It pays for:
  • Clinical breast exams
  • Diagnostic testing if your screening test results are abnormal
  • Human papillomavirus (HPV) tests
  • Mammograms (breast cancer screening).
  • Multiple sclerosis testing for those who are high risk.
  • Pap tests (cervical cancer screening).
  • Pelvic exams
You don’t have to pay a:
  • Co-payment.
  • Deductible.
  • Premium.
You must use a medical provider in the program. You can enroll if you:
  • Are a woman between ages 40 and 64.
  • Don’t have health insurance, or
    • Have insurance that doesn’t include routine check-ups and screenings.
    • Can’t pay the deductible or co-payment.
  • Live in Wisconsin
  • Meet income requirements (at or below 250% of the federal poverty level)
To apply for the Wisconsin Well Woman Program, you can contact the Brown County Coordinator:

Imelda Sanchez, RN
Brown County Public Health
111 N Jefferson St.
Green Bay, WI 54301
Phone: 920-448-6430
Fax: 920-448-6479
Imelda.Sanchez@browncountywi.gov

Sanchez also serves as the program coordinator for Oconto, Shawano, Marinette, Manitowoc, Door, and Kewaunee Counties.

Online, the National Cervical Cancer Coalition curates a list of helpful links for patient support and advocacy.

Brown County Public Health echoes the message of the NCCC and American Sexual Health Association (ASHSA) in urging every woman to talk with her health care provider about all the prevention tools at their disposal: Pap and HPV tests and immunizations that reduce the risk of cervical cancer.

Stay Healthy, Brown County!

For more information about a growing list of health-related topics, visit the Healthy Herald, Brown County Public Health’s blog at stayhealthybc.com.

Blog Resources
https://www.nccc-online.org/
https://www.cdc.gov/cervical-cancer/about/index.html
https://www.technologynetworks.com/biopharma/news/no-cervical-cancer-cases-following-hpv-shot-in-scotland-383093
https://pmc.ncbi.nlm.nih.gov/articles/PMC9554067/
U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; https://www.cdc.gov/cancer/dataviz, released in June 2024.
https://www.dhs.wisconsin.gov/wwwp/index.htm
https://www.nccc-online.org/resources/links/