Women should be aware of the different types of cancer that can occur in their reproductive system. A reliable screening test is only available for cervical cancer. The other types of cancer – ovarian, uterine, vaginal and vulvar cancer – have no reliable screening test. The best protection is to report promptly any changes that last longer than two weeks to your health care provider for accurate evaluation. As with all cancers, early detection means a better chance for a cure and a wider variety of treatment options.

 Cervical cancer

More than 12,000 women in the United States are diagnosed with cervical cancer each year and almost 4,000 of them will die as a result.Cervical cancer is the easiest gynecologic cancer to prevent if women get regular screening tests and follow-up treatment. Two screening tests can detect cervical cancer early, when it is most easily curable.

  • The Pap test (or Pap smear) looks for cell changes on the cervix that might become cervical cancer if not treated. It can be done in a doctor’s office or clinic. The cells that are collected are analyzed by a laboratory to determine if they are normal. Along with the Pap test, your doctor will often perform a pelvic exam to check the uterus, ovaries and other organs.
  • The test for human papillomavirus (HPV) looks for the virus that can cause cell changes in the cervix. The lab can also test the cells for HPV if the HPV test is performed at the same time as the Pap test. Woman who are over 30 years of age may choose to have an HPV test in addition to the Pap test.

The U.S. Preventive Services Task Force recommends a Pap test for all women between the ages of 21 and 65, regardless whether they are sexually active or not. If a woman’s Pap tests continue to be normal, she can wait three years until the next Pap test.

Women over age 65 who have had normal Pap tests results for several years can stop getting Pap tests if their doctor agrees. Also, women who have had their cervix removed as part of a total hysterectomy for non-cancerous conditions may stop having Pap tests.

The Pap test only screens for cervical cancer and cannot screen for ovarian, uterine, vaginal or vulvar cancers.

 Ovarian cancer

September is ovarian cancer awareness month. Ovarian cancer causes more deaths than any other cancer of the reproductive system. For women ages 35 to 74 years, ovarian cancer is the fifth leading cause of cancer deaths, according to the American Cancer Society. One in 72 women will develop ovarian cancer in their lifetime. In Arkansas, approximately 200 women are diagnosed with ovarian cancer each year and 150 of them will die from this disease.

The high death rate is largely because there is no simple and reliable way to screen for ovarian cancer in women who do not have any signs or symptoms.

The best way to reduce your risk of ovarian cancer is to pay attention to your body. Know what is normal for you. If you notice any changes in your body that last longer than two weeks talk to your doctor about them.

Symptoms of ovarian cancer are often vague and can be attributed to other problems. The most common signs include:

  • Vaginal bleeding or discharge from your vagina that is not normal for you
  • Pain in the pelvic or stomach area
  • Back pain
  • Bloating (the area below your stomach swells or feels full)
  • Quickly feeling full while eating
  • A change in your bathroom habits, such as having to pass urine very badly or very often, constipation or diarrhea

Most women who get ovarian cancer are not at high risk for the disease. About 90 percent of women who get ovarian cancer are over 40 years of age. The majority of cases occur past the age of 60.

The conditions that may increase the risk for ovarian cancer include:

  • Being middle age or older
  • Have close family members with ovarian cancer
  • Are of Eastern European Jewish (Ashkenazi) background
  • Have the BRCA1 or BRCA2 genetic mutation, or a mutation associated with Lynch syndrome
  • Have had a previous cancer of the breasts, uterine, colorectal area, cervix or had melanoma
  • Never given birth
  • Have had trouble getting pregnant
  • Have endometriosis (tissue from the uterus lining grows elsewhere in the body)
  • Have taken estrogen by itself, without progesterone, for 10 or more years

Factors that can reduce ovarian cancer risk include:

  • Having given birth
  • Breastfeeding
  • Having used birth control pills
  • Having had a tubal ligation (also called getting your tubes tied)
  • Having had both ovaries removed or a hysterectomy

Uterine cancer

The most common type of uterine cancer is also called endometrial cancer because it forms in the endometrium – the lining of the uterus. Like ovarian cancer, there is no way to test for uterine cancer if there are no symptoms.

Uterine cancer’s most common symptoms include pain or pressure in your pelvis, or vaginal discharge or bleeding that is not normal for you. Bleeding may be abnormal because of how heavy it is or when it happens, such as after menopause, between periods, or any other bleeding that is longer or heavier than is normal for you.

Uterine cancer diagnosis is made based on the results of an endometrial biopsy or a transvaginal ultrasound. These tests can be done in a doctor’s office or clinic.

Other cancers

Two other types of cancers – vaginal and vulvar cancers – also lack simple and reliable testing methods.

Most vaginal cancers do not cause signs and symptoms in the early stages. If there are symptoms, they may include:

  • Vaginal discharge or bleeding that is not normal for you. The bleeding may be abnormal because of how heavy it is, or when it happens, such as bleeding after you have gone through menopause; bleeding between periods; or any other bleeding that is longer or heavier than is normal for you.
  • A change in bathroom habits, such as having blood in the stool or urine, going to the bathroom more often than usual or constipation.
  • Pain in the pelvis, especially during sex or when you urinate.

Vulvar cancer is usually accompanied by symptoms, including:

  • Itching, burning, or bleeding on the vulva that does not go away
  • Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal for you
  • Skin changes in the vulva, including what looks like a rash or warts
  • Sores, lumps or ulcers on the vulva that do not go away
  • Pain in your pelvis, especially during sex or when you urinate

Information adapted from the Centers for Disease Control and Prevention website.