The Most Preventable Cancer You Should Know About
Cervical cancer used to be one of the leading causes of cancer death among American women. Today, thanks to two powerful public health tools (the HPV vaccine and routine screening), it is one of the most preventable and curable cancers when caught early.
Yet it still kills over 4,000 women per year in the United States, almost always because screening was missed or delayed.
Understanding how cervical cancer develops, what HPV actually is, and what your screening schedule should look like is one of the most impactful things you can do for your long-term health. This is not scary. This is empowering.
What Is HPV?
Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. It is so common that the CDC estimates nearly all sexually active people will be infected with at least one type of HPV at some point in their lives.
There are over 200 types of HPV. The majority cause no symptoms at all and are cleared by your immune system within 1 to 2 years. A few cause genital warts (low-risk types, primarily HPV 6 and 11). And a small subset, the high-risk types (primarily HPV 16 and 18), can cause persistent infections that, over years to decades, lead to cellular changes on the cervix that may progress to cervical cancer if undetected.
The key word is may. Most HPV infections, even high-risk ones, resolve on their own. Screening exists to catch the rare cases that do not.
How Cervical Cancer Develops (Slowly)
Cervical cancer does not appear overnight. It follows a predictable, slow progression:
- HPV infection (extremely common, usually clears on its own)
- Persistent infection with a high-risk strain (a minority of cases)
- Cervical Intraepithelial Neoplasia (CIN): Precancerous cell changes visible on biopsy. Graded CIN1 (mild, often regresses), CIN2 (moderate), CIN3 (severe/carcinoma in situ)
- Invasive cervical cancer (rare, takes years to decades to develop from initial infection)
This slow progression is precisely why screening works so well. We have a large window to detect and treat precancerous changes before they become cancer. That is the entire point of your Pap test and HPV test.
ACOG Screening Guidelines: What You Actually Need
ACOG updated and reaffirmed its cervical cancer screening guidelines in 2021/2023 [1]. Here is the current recommendation:
Ages 21-29
- Pap test (cytology) alone every 3 years. HPV co-testing is not recommended before age 30 because HPV infections are extremely common and almost always transient in this age group.
Ages 30-65
- Preferred: Co-test (HPV + Pap) every 5 years
- Acceptable alternative: Primary HPV test alone every 5 years
- Acceptable alternative: Pap test alone every 3 years
Over 65
- Screening can be discontinued if you have had adequate prior screening with normal results and no history of CIN2 or higher in the past 25 years.
Important Exceptions
- Immunocompromised patients (including HIV-positive): Follow a more intensive screening schedule as directed by your provider.
- History of CIN2/CIN3 or cervical cancer: Continue surveillance for at least 25 years after treatment.
What Happens at Your Screening Appointment
A cervical cancer screen is performed during a pelvic exam (often part of your Well-Woman visit):
- A speculum is gently inserted to visualize the cervix.
- A soft brush or spatula collects cells from the surface of the cervix.
- The sample is sent to a lab for HPV testing, cytology (Pap), or both.
- The entire collection takes less than 30 seconds.
Results typically arrive within 1 to 2 weeks. Your MomDoc provider will contact you with results and next steps.
When Results Are Abnormal: What Happens Next
An abnormal result can be anxiety-inducing, but the vast majority are not cancer. Here is the typical follow-up pathway:
- HPV-positive, normal cytology: Repeat testing in 1 year. Most infections will clear.
- HPV 16 or 18 positive: Proceed directly to colposcopy (a magnified examination of the cervix with possible biopsy).
- Abnormal Pap (ASCUS, LSIL): Colposcopy or repeat testing depending on HPV status.
- High-grade Pap (HSIL): Prompt colposcopy and biopsy.
- Confirmed CIN2/CIN3: Treatment via LEEP procedure (loop electrosurgical excision) or cold knife cone biopsy to remove the abnormal tissue. Both are outpatient procedures.
The HPV Vaccine: Your First Line of Defense
The HPV vaccine (Gardasil 9) is one of the most significant cancer prevention tools in modern medicine. It protects against 9 HPV types, including the two responsible for approximately 70% of cervical cancers (HPV 16 and 18).
- Recommended age: 11-12 years (can start as early as 9)
- Catch-up vaccination: Through age 26 for everyone
- Shared clinical decision-making: Ages 27-45 (the vaccine may still offer benefit for those not previously vaccinated)
The vaccine is most effective before exposure to HPV, which is why early administration is recommended. It is safe, thoroughly studied, and reduces cervical cancer risk by approximately 90% for the HPV types it targets [2].
Myth Busting: "Only Promiscuous People Get HPV"
This is categorically false and deeply harmful. HPV is transmitted through skin-to-skin contact during any intimate contact, including vaginal, anal, or oral sex. You can contract HPV from your very first sexual partner. Condoms reduce transmission but do not fully prevent it because HPV can infect areas not covered by a condom.
Having HPV says nothing about your sexual history, your character, or your hygiene. It means you are a normal human being who has had intimate contact with another human being.
The MomDoc Approach
- Screening integrated into your Well-Woman exam: We perform cervical cancer screening at the appropriate intervals during your routine annual visit.
- Clear, non-judgmental communication: We explain every result in plain language and never let you leave with unresolved questions.
- In-house colposcopy and LEEP: If follow-up is needed, MomDoc performs these procedures in our offices with local anesthesia, avoiding the need for hospital-based surgery.
- HPV vaccination counseling: We discuss the vaccine with patients of all ages and help parents navigate the decision for their adolescents.
Schedule Your Screening
If you are overdue for cervical cancer screening, or if you have questions about HPV, vaccination, or an abnormal result, call MomDoc at 480-821-3601 or book a Well-Woman appointment online.
This content is for informational purposes only and does not replace professional medical advice. Always consult your MomDoc provider regarding your specific screening needs.