In the last four decades, the incidence of cervical cancer has declined by 50% in the U.S., thanks to advances in care, but the risk remains. Cervical Cancer Awareness Month highlights the importance of prevention, early detection, and lifesaving screenings and treatments for a disease that remains a significant health concern for women.
“We’ve made great improvements and exciting advances, but it’s far from being eradicated,” said Ioana L. Bondre, MD, MPH, a gynecologic oncologist with UT Physicians.
In 2025, the American Cancer Society expects about 13,000 new cases of cervical cancer and about 4,000 deaths from this disease.
Advances in treatment
Researchers have made strides in treating a form of the disease called locally advanced cervical cancer.
“Locally advanced cervical cancer is limited to the pelvis, which includes the bladder and rectum,” said Bondre, an assistant professor of obstetrics, gynecology, and reproductive sciences at McGovern Medical School with UTHealth Houston.
Advances in treatment over the last two years have steered care teams to incorporate immunotherapy and chemotherapy earlier in treatment.
“These interventions used to be reserved for distant metastatic cancer, meaning the cancer had spread to distant organs or lymph nodes,” explained Bondre. “Now, we are using immunotherapy and chemotherapy earlier in the treatment of high-risk, locally advanced cancer, and that has improved outcomes.”
Immunotherapy vs. chemotherapy
Immunotherapy is a form of targeted cancer treatment that works differently than standard chemotherapy.
“Cancer cells sometimes have mechanisms to evade or hide themselves from our immune system,” said Bondre. “Immunotherapy unveils the cancer cells to our immune system, therefore helping our immune system fight the abnormal cells.”
Chemotherapy works by killing off all cancer cells that are rapidly dividing and indiscriminately kills healthy cells with bad cells.
“This is what leads to hair loss, nausea, vomiting, and a dip in blood cell counts over time,” said Bondre.
In cervical cancer treatment, immunotherapy is used in conjunction with chemotherapy and radiation therapy for better outcomes.
Preventable cancer
Cervical Cancer Awareness Month is an opportunity to remind women that cervical cancer is considered a preventable cancer. There is protection through vaccination and screening.
Vaccination
Unlike most cancers, there is primary prevention for cervical cancer in the form of the human papillomavirus (HPV) vaccine.
The HPV vaccine is recommended for boys and girls starting at age 11 but can be given as early as 9 years old. If administered before age 15, it is a two-dose series. If given from ages 15-26, the vaccine is a three-dose series.
“HPV is a sexually contracted virus, so the best time to become protected against the HPV virus is before first intercourse,” said Bondre.
Receiving the vaccine does not increase the likelihood of preteens and teens having intercourse at an earlier age.
The vaccine can be given up to age 45, based on individual cases.
“It’s not a routine recommendation past age 26, but the FDA approval exists as long as the patient and their provider discuss it in detail,” said Bondre.
Screening
After vaccination comes the second line of defense: regular Pap smear screening.
“Sometimes there is a misconception that if somebody has been vaccinated, they no longer need regular Pap smears, and that is not true,” said Bondre.
A Pap test is recommended every three years from ages 21-29. If results are normal, the test can be spaced out every five years from ages 30-65. Abnormal results will change the frequency of testing.
2025 outlook
Despite the advances in protection and awareness, cervical cancer remains a leading cause of cancer death for women in the U.S. and is most commonly diagnosed in women 35-44 years old.
“It is a disease that tends to affect younger women, so it’s really important that they get the appropriate screening and protection,” said Bondre. “This is a terrible disease that is preventable. The best thing you can do for yourself or your loved one is to follow prevention guidelines.”