Almost everyone who has sex will at some point get the virus that can cause cervical cancer.
HPV, or human papillomavirus, is so prevalent that it’s like the “common cold of the cervix” for women, says Dr. Olivia Khouri, a gynecologic oncologist at NYU Langone Health.
“It's a sexually transmitted infection — incredibly common, incredibly prevalent among sexually active adults,” Khouri tells TODAY.com.
“It especially has an affinity for affecting the cervix.”
A healthy immune system typically clears the infection. But some strains of HPV can linger in the cervix — which connects the uterus to the vagina — causing a persistent infection that can then lead to abnormal cells, pre-cancerous changes, and ultimately to cervical cancer, Khouri says.
But the doctor wants women to know certain high-risk strains of HPV are preventable thanks to the HPV vaccine and routine screening that can find the cancer early, including the HPV test and the Pap smear. Women can now also opt for a self-administered HPV test.
Incidence of the disease has plummeted for women in their early 20s — the first generation to benefit from the HPV vaccine — but it’s been increasing in women in their 30s and early 40s, according to the American Cancer Society.
As Khouri treats patients with cervical cancer and since January is Cervical Cancer Awareness Month, it’s especially top of mind.
“Sure — this disease can impact everyone. I always tell everyone HPV is ubiquitous,” she says.
“(But) it's not a cancer that I worry about developing myself and not catching early because we have such effective screening methods for it.”
Cervical cancer often has no symptoms and grows slowly, so the earliest sign is usually an abnormal Pap smear, the Society of Gynecologic Oncology notes.
But if the disease were to progress, here are the warning signs Khouri would look for in her own body:
Unexpected or Irregular Vaginal Bleeding
This is the most common symptom a woman might notice and includes bleeding between periods, after sex or after she’s gone through menopause.
The bleeding happens because the cervix can become inflamed.
“As a tumor develops, or even a pre-cancer, that inflammation can lead to irritation, especially with intercourse,” Khouri says.
Seeing blood after douching would also be a concerning symptom. (Khouri and other doctors advise against douching in general.)
Routine screening for cervical cancer stops at 65, but women who are that age or older have the highest mortality rates from the disease, researchers have found.
An HPV infection that was previously cleared by the body may reactivate as the immune system changes with age so any postmenopausal bleeding or abnormal discharge should warrant a trip to the gynecologist, Khouri cautions.
Abnormal Vaginal Discharge
Women should be especially aware of a clear or watery discharge, Khouri says. It may be continuous and contain some blood.
Heavier or Longer Periods
“Any kind of real change in the bleeding pattern should be something that warrants a workup,” she notes.
Pelvic Pain
This may feel like premenstrual cramps, but doesn’t necessarily coincide with a period, the doctor says.
It could also be pain during sex.
Leg Swelling
A locally advanced cervical cancer can impact the lymphatic drainage in the pelvis, which can lead to accumulation of fluid in the legs, Khouri notes.
Problems Urinating or Having a Bowel Movement
“The cervix sits right behind the bladder, right in front of the rectum. So as a tumor grows in the cervix, it can grow and invade the bladder, can invade the rectum,” Khouri says.
This may include seeing blood in the urine or stool, experiencing difficulty emptying your bladder, or noticing constipation or thin stools.
How to Decrease Your Risk
An HPV infection is the biggest risk factor. So getting HPV vaccination before a person is sexually active “hugely reduces the risk” of cervical cancer because it prevents acquiring the highest risk strains of HPV, Khouri notes.
“It's most effective when it's given in the pre-adolescent age group, so 9 to 11 years old,” she says.
The vaccine series can be started up to age 26.
Other risk factors for cervical cancer include smoking, having a weakened immune system, long-term use of birth control pills and having multiple full-term pregnancies, according to the American Cancer Society.
Screening with a Pap test should start at age 21. Once women turn 30, an HPV test can be added to the routine.
“The most important thing that I do is get an annual pelvic exam and then a Pap test whenever it's indicated,” Khouri says.
“I have a lot of confidence in the screening… We're very good at catching cervical cancers early, and when we catch them early, they're typically curable.”
TODAY’s Symptom Check series features doctors, specialists and health experts who reveal the warning signs they’d look for in their own body when it comes to cancer and other diseases.
