Prevention of Gynecological Cancers

Screening: Recently, the U.S. Food and Drug Administration (FDA) approved Gardasil ® to protect against the Human papillomavirus (HPV) in females nine to 26 years of age to prevent cervical cancer. The Centers for Disease Controls' (CDC's) National Immunization Program (NIP) and the federal Advisory Committee on Immunization Practices (ACIP) have recommended the use of the HPV vaccine. Although the vaccine could prevent up to 70% of cervical cancer cases, it can't prevent infection with every virus that causes cervical cancer. Routine Pap tests to screen for cervical cancer remain very important. Another vaccine against HPV is in clinical trials (Cervarix ®), and its results are unknown at this time.

Recommendations for prevention of cervical cancer include regular cervical cancer screening (Pap tests) for all women (within three years of when a woman begins sexual activity or at age 21) or HPV vaccination for girls and women aged nine to 26. The HPV vaccination for women aged 27 or older is not supported. All women receiving the HPV vaccine should continue to receive regular cervical cancer screenings (Pap tests) according to established screening recommendations.

Other prevention factors: Other factors recommended by healthcare professionals to prevent gynecological cancers include limiting the number of sexual partners, getting screened regularly with a Pap test, and following up any abnormal Pap test results as recommended by a healthcare provider.

Dietary factors: Dietary factors that significantly reduce the risk of gynecological cancer include eating more antioxidant-containing fresh fruits and vegetables and decreasing the intake of red meats and foods high in animal fat (such as dairy products - milk, cheese, sour cream). A study found the strongest link between dietary risk factors and ovarian cancer was meat and cheese intake. The same study found significantly reduced risk of all ovarian cancer with higher tomato consumption. Other studies have found no link between preventing ovarian cancer and dietary factors.

Exercise: An increase in physical activity has been reported to decrease the chances of developing cancer. High levels of sedentary behavior may increase the risk of ovarian cancer. A doctor can advise the patient as to what type of exercise would be best for that individual.

Oral contraception (OC, birth control pills): Studies have found a correlation between birth control pill use and a reduced risk of ovarian cancer. However, other studies have shown that oral contraception increases a woman's risk for breast cancer as well liver and cervical cancer.

Pregnancy and breastfeeding: Having at least one child lowers the risk of developing ovarian cancer. Breastfeeding a child for a year or longer also may reduce the risk of ovarian cancer.

Tubal ligation or hysterectomy: The Nurses' Health Study, which followed thousands of women for 20 years, found a substantial reduction in ovarian cancer risk in women who had had tubal ligations. The procedure also has been shown to reduce ovarian cancer risk among women with mutations in the BRCA1 gene, although how the procedure helps is uncertain. The Nurses' Health Study also indicated that having a hysterectomy may reduce ovarian cancer risk, but not by as much as tubal ligation. However, there are risks associated with tubal ligation and hysterectomy that should be discussed with a qualified healthcare professional. Studies conducted at the Alan Guttmacher Institute found that, depending on the sterilization technique used, up to two percent of women can expect a major complication at the time of operation. Patients may suffer from such complications as infection, injury to the bladder or bleeding from a major blood vessel, and burning of the bowel or other structures. A study in Britain followed 374 post-tubal patients and found that 43% had subsequent gynecological treatment for such conditions as heavy menstrual bleeding, menstrual disturbances requiring hormonal treatments, cervical erosion, ovarian tumors, and recanalization of the fallopian tubes requiring a second operation. The risk of cervical cancer among a study of 489 post-tubal women was 3.5 times the normal rate.

Weight control: The incidence of obesity is increasing in the developed world such that it now contributes as much as smoking to overall cancer deaths. Women with a body mass index (BMI) >40 have a 60% higher risk of dying from all cancers than women of normal weight. They are also at increased risk for gynecological cancer.

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