By Kelly Shanahan

It doesn’t have the pink ribbons and 5K runs of October (breast cancer awareness month), but January is just as important: it is cervical health awareness month. More than 12,000 women will be diagnosed with cervical cancer in 2013 and 4,000 will die.

This statistic is especially tragic because cervical cancer is a preventable disease. Ninety-nine percent of cervical cancer is caused by a sexually transmitted virus, the human papilloma virus, better known as HPV. HPV is a large family of viruses, with about 100 members. Some types of HPV cause common warts, others genital warts, and one particular branch of the HPV family — high risk HPV — actually causes cancer — cervical, vaginal, anal and even mouth and throat cancers.

While cervical cancer is the best know, and obviously can only affect women, approximately 30 percent of oral cancers are caused by HPV, and this affects men and women. HPV is spread by skin-to-skin contact. It can infect anyone who has had any type of sexual or intimate encounter; it does not require exchange of bodily fluids.

Kelly Shanahan

HPV can be contracted with one sexual encounter, remain dormant and only be detected years later. Because the strains of HPV that cause cervical cancer are different than the ones that cause visible warts, HPV can unknowingly be passed to a sexual partner.

It is estimated that 70 percent of people will come in contact with HPV during their life. When we are young, the immune system is stronger and may be able to completely eliminate the virus from the body — until a new partner brings a new strain of HPV into the picture. The older we are, the less likely it is that HPV will be eliminated completely. This is the reason that HPV testing is recommended at the time of a pap smear for women over 30.

Use of a condom 100 percent of the time with 100 percent of sexual acts — vaginal, anal, oral or even contact with the genitals without what we think of as intercourse (I call this “close to sex”) — can decrease the odds of contracting HPV. One study showed that using condoms correctly with every sexual act could lower the HPV infection rate by 70 percent. But because HPV can infect areas that are not covered by condoms, condoms do not completely protect against HPV.

There is a vaccine available that if given before any type of sexual or intimate activity can protect against the two types of HPV that cause 90 percent of genital warts and the two types that cause 70 percent of cervical cancer. This vaccine, called Gardasil, is recommended for girls and boys and the first dose ideally is given between 11 and 12 years of age. Just think about it: if every young girl and young boy in this country were vaccinated prior to ever having sex, we would eliminate 70 percent of cervical cancer in one generation.

The Gardasil vaccine is a series of three shots given over the course of six months. It is covered by most insurance plans and many health departments and school districts offer it for low or no cost. Even if you have already had sex, the vaccine can be given up to age 26 — again to females and males. If someone has been sexually active already, there is a chance that exposure to one type of HPV covered by the vaccine may have already happened. If this is the case, the vaccine will not prevent problems caused by that strain, but odds are you haven’t been exposed to all four strains so the vaccine can still provide great benefit.

For women, pap smears are the best way to screen for cervical cancer. The goal is to find abnormal cell changes — and monitor or treat them — before cancer develops. Because we understand much more about cervical cancer and how it develops — again 99 percent is caused by sexually transmitted high risk HPV — guidelines for pap smears have changed in recent years. A pap smear may not be necessary for every woman every year, but a visit to your gynecologist annually is still recommended. As I tell my patients, “your job is to show up every year and my job is to figure out what you need.”

So this January, let’s pay attention to what we can’t see — the cervix — and remember to vaccinate early (girls and boys), get your pap smear regularly and have an HPV test when recommended by your doctor.

Together we can eliminate cervical cancer.

Kelly Shanahan is a board certified gynecologist who has been serving the women of Lake Tahoe and the Carson Valley for 19 years. She offers HPV vaccination, pap smears, management of abnormal pap smears and counseling to help you learn how best to decrease your risk of HPV and other STDs. The mother of a teenaged daughter, she is committed to trying to wipe out HPV in her daughter’s lifetime. Call (530) 542.4961 or (775) 782.7300 to schedule your appointment.