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Cervical Cancer Awareness and Prevention

by Andria Apostolou, Ph.D., MPH

Each January we observe cervical cancer awareness month and reflect on a disease that affects over 12,000 women in the U.S. each year with approximately 4,000 associated deaths. Although the rate of cervical cancer in American Indian/Alaska Native (AI/AN) women has decreased over time, AI/AN women continue to have 4.2 times the rate of illnesses and deaths due to cervical cancer when compared to non-Native women. Often, AI/AN women are diagnosed with cervical cancer in more advanced stages making successful treatment and cure more difficult.

Although the cause of cervical cancer is not completely understood and research continues, it is known that sexually transmitted Human Papilloma Virus (HPV) plays an important role in the development of cervical cancer. While HPV is common and almost every sexually active person will get it at some time in their life, few men and women will go on to develop cancer. When the body’s immune system can’t get rid of a high-risk HPV infection, it can linger over time and turn normal cells into abnormal cells and then cancer. Risk factors associated with cervical cancer include early onset of sexual activity, having multiple sex partners, exposure to other sexually transmitted infections, smoking, and having a weakened immune system. Pain during sex or unexplained vaginal bleeding can be indicative of illness, but there are often no symptoms associated with cervical cancer, and diagnosis requires an examination and testing by a health care provider.

For Patients

Cervical cancer is preventable through regular screening and treating any abnormalities early-on before they progress to cancer. Screening with a Papanicolaou (Pap) test every three years is recommended for all women ages 21 to 65 years and screening with a Pap and HPV test is recommended every five years for women ages 30 to 65 years. If the results of any cervical cancer screening test show any abnormalities, additional testing known as a colposcopy test may be performed at your health care provider’s office.

One of the most important ways to protect yourself from HPV and related cancers is by getting vaccinated for HPV. The HPV vaccine is recommended for both girls and boys at the age of 11-12, as well as for older adolescents and younger adults. Building your immune system with a healthy diet and exercise, while stopping or never starting smoking is important as well. Also, decreasing your high risk sexual activity by using condoms and limiting the number of sexual partners can help. All of these actions can support your goal of reducing your risk of cervical cancer.

For Providers

Colposcopy Training Available

The IHS Division of Epidemiology and Disease Prevention, through partnerships with the Southcentral Foundation and the University of New Mexico School of Medicine, offers basic and refresher colposcopy training courses open to IHS, tribal, and urban health organization clinical providers. The training is free, but participants are responsible for any travel and other associated costs of attendance. The course is appropriate for providers wishing to initially learn how to perform colposcopy as well as practicing colposcopists. These courses bring together an outstanding national faculty to update participants on the natural history of HPV-related lower genital tract disease, cervical cancer prevention, and to teach the basics of colposcopy for health care providers wishing to add the skill to their practice. A combination of lecture format, interactive case discussion, and simulations will be used. For further information, contact Roberta Paisano at

Other Training Resources

Primary health care providers who treat female patients can also receive continuing education credits for enhancing overall gynecologic cancer awareness by completing the CDC’s online six-module continuing education course Exit Disclaimer: You Are Leaving , Gynecologic Cancer Curriculum Inside Knowledge: Get the Facts about Gynecologic Cancer. This resource and available training material is relevant for a variety of care settings and providers, including primary care physicians (those practicing and in training) in internal medicine, family medicine, or obstetrics and gynecology, as well as nurses and physician assistants.

Related Content:

IHS Observes Breast Cancer Awareness Month

A Patient’s Perspective on Colorectal Cancer Screening in the Indian Health System

IHS Highlights Importance of Vaccination and Regular Cancer Screenings to Prevent Cervical Cancer

CDC’s Cervical Cancer Website Exit Disclaimer: You Are Leaving 

CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Website Exit Disclaimer: You Are Leaving’s Cervical Cancer Website Exit Disclaimer: You Are Leaving 

American Indian Cancer Foundation Exit Disclaimer: You Are Leaving 

Andria Apostolou, Ph.D., MPH
Andria Apostolou, PhD, MPH is a Senior Epidemiologist with the IHS Office of Public Health Support Division of Epidemiology and Disease Prevention. She also serves as the IHS National STD Program Lead.

Katia Fortune is a CDC Public Health Associate assigned to the IHS Office of Public Health Support Division of Epidemiology and Disease Prevention and Suzanne England DNP, APRN is the Maternal Child Health Consultant in the IHS Great Plains Area also contributed to this blog.