Let's test your knowledge of cervical cancer.

At the recent meeting of the Southeast Health Coalition, Jo Bottorff, specialist in screening systems for the American Cancer Society, had a handout with some little-known information about cervical cancer.

Let's test your knowledge of cervical cancer. Here goes:

1. How many cases of invasive cervical cancer were expected to be diagnosed in the U.S. in 2016? A. 12,990, B. 10,259, C. 9,210; D. 29,2030

2. How many women in the U.S. were expected to die from cervical cancer in 2016? A. 5,606 B. 8,310 C. 4,120 D. 12,430

3. Over the last 30 years, the cervical cancer death rate has gone down by more than 50 percent. True or false?

4. Cervical cancer tends to occur in midlife. True or false?

5. In the U.S., which women are most likely to get cervical cancer? A. Hispanic B. African American C. Asian D. White

6. Which of these are risk factors for cervical cancer? A. Human papilloma virus infection (HPV) B. Immunosuppression C. Smoking D. Chlamydia infection E. Diet low in fruits and vegetables F. Being overweight G. Long-term use of oral contraceptives H. Poverty

7. HPV vaccines can protect against 90 percent of cervical cancers. True or false?

8. Women with early cervical cancers and pre-cancers usually have no symptoms. True or false?

9. Did the American Cancer Society play a role in the development of the PAP test? Yes or no?

10. When cervical cancer is diagnosed early, when it has not spread, the 5-year survival rate is 92 percent. What percentage of patients is diagnosed when the cancer is localized? A. 28 percent B. 37 percent C. 47 percent D. 56 percent

11. The American Cancer Society no longer recommends that women get a Pap test every year. True or false?

12. To get the most out of the HPV vaccine, a woman should get it before she has any type of sexual contact with another person. True or false?

ANSWERS

1. A. 12,990. More than 12,000 women get cervical cancer every year and according to the CDC, more than half of them occur among women who have never – or rarely – been screened.

2. C. 4,120

3. True. The main reason for this change was the increased use of the Pap test. This screening procedure can find changes in the cervix before cancer develops. It can also find cervical cancer early ? in its most curable stage.

4. True. Most cases are found in women younger than 50. It rarely develops in women younger than 20. Many older women do not realize that the risk of developing cervical cancer is still present as they age. More than 15 percent of cases of cervical cancer are found in women over 65. However these cancers rarely occur in women who have been getting regular tests to screen for cervical cancer before they were 65.

5. A. Hispanic. In the U.S., Hispanic women are most likely to get cervical cancer, followed by African-Americans, Asians and Pacific Islanders, and whites. American Indians and Alaskan natives have the lowest risk of cervical cancer in this country.

6. All of them are risk factors for cervical cancer. There are some additional ones, as well.

7. False. There are two vaccines (Gardasil and Cervarix) available for protection against the two types of HPV (types 16 and 18) that cause most (70 percent) cervical cancers. Vaccination is recommended for use in girls 11 to 12 years of age, but may be given as young as age 9 and up to age 26. HPV vaccines cannot protect against established infections, nor do they protect against all types of HPV that cause cervical cancer, which is why vaccinated women should still be screened for cervical cancer.

8. True. Symptoms often do not begin until the cancer becomes invasive and grows into nearby tissue. When this happens, the most common symptoms are abnormal vaginal bleeding, an unusual discharge, and pain during intercourse. These signs and symptoms can also be caused by conditions other than cervical cancer.

9. Yes. ACS-funded research helped lead to the development of the PAP test, and ACS helped lead a crusade to educate the public about it.

10. C. 47 percent. Cervical cancer is more often diagnosed at a localized stage in whites (48 percent) than in blacks (39 percent) and in women younger than 50 years of age (59 percent) than in women 50 or older (33 percent). Five-year survival rates for regional and distant stage disease are 57 percent and 16 percent, respectively.

11. True, because it generally takes 10 to 20 years for cervical cancer to develop and overly frequent screening could lead to procedures that are not needed. All women should begin cervical cancer screening at age 21. Women between the ages of 21 and 29 should have a Pap test every three years. They should not be tested for HPV unless it is needed after an abnormal Pap test result. Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every three years. Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical cancer or pre-cancer should continue to be screened according to the recommendations of their doctor.

12. True. The American Cancer Society recommends that the vaccine be given to girls at age 11 to 12, but it may be given as young as age 9 and up to age 26. HPV vaccines cannot protect against established infections, nor do they protect against all types of HPV that cause cervical cancer, which is why vaccinated women should still be screened for cervical cancer.