Any time is an important time to inform ourselves and those close to us about the best practices to identify and prevent cervical cancer incidence. Cervical Health Awareness month was established in 2010 by the 111th US Congress in order to urge “the people of the United States to learn about cervical cancer and its causes, most notably human papillomavirus (HPV), and the importance of early detection.” In 2024 the American Cancer Society estimates more than 13,000 new cases of cervical cancer. Cervical cancer is a growth of cells that starts in the cervix. Human papillomavirus (HPV) plays a role in causing most cervical cancers. HPV is a common infection passed via sexual contact, and it can become dormant for years before developing cervical cancer cells. You can reduce your risk of cervical cancer by scheduling screening tests and receiving a vaccine that prevents HPV infection.

Cervical cancer screening involves a Pap Smear (named after Greek doctor George Papanicolau during his time as a researcher at the New York Hospital) and HPV testing. The test collects cell samples from the outer opening of the cervix in order to identify any precancerous changes or dysplasia caused by HPV. The inception of the Pap test and its widespread use in regular screening has been responsible for up to an 80% decrease in cervical cancer incidence and mortality across populations. Emerging technologies are being studied for primary HPV testing and even the option of self-sampling for HPV cervical cancer screening. These include dual staining to detect tumor suppressor proteins which can improve detection of HPV-associated cervical precancers and HPV DNA methylation which is a potential biomarker for clinically relevant benign and carcinogenic HPV infections. These tests show some good reproducibility when compared to cytology (Pap smear) and colposcopy (using a microscope to examine the cervix) which are the gold standards for identifying precancerous cells. But they need to be validated. The National Cancer Institute has initiated efforts to study self-sampling, and is conducting a trial of Self-Sampling for HPV testing to Improve Cervical Cancer Prevention (SHIP Trial) in community settings across the US. It is an effort to reach never-screened and under-screened women who account for more than 50% of cervical cancer cases annually. If their results are favorable, self-sampling may have a role as a primary approach to initial screening. Studies have shown that the risk of developing invasive cervical cancer is three to ten times higher in women who have not participated in screenings. If you have any further questions about cervical cancer or the available screening, do not hesitate to reach out to your gynecologist or women’s healthcare provider. You can also seek more information at http://www.cancer.gov/types/cervical.

John A. Cotter
Dartmouth College MPH 2026