Cervix

Uterus

Vagina

Normal Cells vs. Abnormal Cells

Columnar cells are fragile and delicate and transform into tougher, more durable squamous cells in the transformation zone.

Your body is made up of trillions of cells. Within each *normal* cell, there are genes that give directions on when to grow, multiply, group, and die.

*Abnormal* cells disobey these directions. Kind of like *that* guest at a party who insults the host, ignores the cocktail napkins, and doesn't leave when the party is over. 

In other words, these cells multiply, divide, and behave in unplanned ways.

Beyond getting Pap tests and the HPV vaccine, there are things you can do in your daily life that support your immune system, and in turn, can help you fight off viruses and disease. These lifestyle-based recommendations are all backed-by-science and 100% in your control. 

People talk smack about the Pap because it can feel invasive, uncomfortable, and straight-up awkward. But the rise of this easy-to-perform, inexpensive, and highly-reliable test has made a colossal impact on the decline of cervical cancer incidence.  

The Pap test is named after Greek immigrant, Dr. Papanikolaou. He rightly believed and proved that most forms of cervical cancer begin with an infection and the changes in the cells that ultimately become cancer cells progress in a predictable fashion over time. He is the pioneer behind early cervical cancer detection.

In a Pap test, cells are taken from the cervix using a speculum and examined under a microscope. Pap tests detect abnormal cells. 

We are an interdisciplinary team of doctors, researchers, designers, and technologists who have seen firsthand how misinformation leads to bad medicine, ill-informed choices, and poor health outcomes.

Our mission is to enable every female to achieve their definition of optimal health by building products, tools, and services through a distinctly female, science-backed lens. 

We believe that sound science need not be confusing, and that choice in healthcare starts with presenting patients and providers with the facts.


Mild dysplasia

Severe dysplasia

Referred to as the “common cold” of the sexually active world, HPV, aka the human papillomavirus, is the most common sexually transmitted infection worldwide. The Centers for Disease Control states that almost *all* sexually active people will contract at least one HPV strain at some point in their lives. 

A virus is a small infectious agent that replicates in living cells. A strain is a certain biological form of a microorganism. Viruses are like families and strains are like the cousins within the extended family — related but not exactly identical.

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So, whats going on down there?

Were all about the

Only people with cervixes can get cervical cancer but HPV affects all of us. 

Males are not tested for HPV but they are carriers and transmit the virus. They can also suffer from the ramifications of the untreated virus. It is estimated that HPV causes 9,000 new cancers in males in the U.S. every year, including nearly all anal cancers, 63% of penile cancers, and 70% of throat cancers. 

Lets talk about

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Get moving! 

Physical activity stimulates the immune system. Strong immune systems are better at fighting off viruses and may support the body in fighting off cervical cancer [21].

Skip the cigs! 

Smoking limits the immune system's ability to fight off HPV. Females who smoke are about twice as likely as non-smokers to get cervical cancer [16, 26]. 

Get your vitamin D! 

80-90% of females are vitamin D deficient. Vitamin D helps with the stimulation of antibody formation. There is clinical research showing that vitamin D supplementation can lead to the regression of mild dysplasia. 20 minutes in the sun 3x a week can make all the difference [13, 18, 23].

Nutrition is vital! 

We're all about nutrient delivery and we think of #FoodasMedicine. Diets high in carotenoids, foods with red, yellow, and orange pigment (think squash, oranges, apricots) and vitamin C may help reduce cancer risk [7].

Limit chronic stress! 

Or better yet, learn how to modulate the impact of allostatic load on your immune system. Does this sounds like a different language? Learn more and take the quiz at www.stressquiz.asktia.com

The HPV test looks for the virus. This test does not detect precancerous or cancerous cells. It does, however, identify which strains (high-risk or low-risk) are present.

A colposcopy examines abnormal cells through a microscope and a bright light. Think: a close-up on the cervix, vulva, and vagina.

Depending on your results your provider may recommend getting retested via a follow-up Pap in a few months to a year.

An abnormal Pap is a broad categorization that can mean a bunch of different things — it can indicate HPV, a different kind of infection, or unusual cells on the cervix. 

Your Care Provider may follow up with additional testing to get more information on what’s going on down there.

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Your cervix can bounce back from anything (just like you). Made from connective tissue, it is the lowest part of the uterus that connects to the vagina. It stretches slightly during menstruation and expands up to 10 centimeters during childbirth.

Abnormal cells

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Cancer

Despite what it sounds like, the transformation zone is not a ride at a county fair, it is the area that surrounds the opening of the cervix and where “abnormal cells” most commonly develop. 

There are two types of cells on the surface of the cervix: squamous and columnar. Throughout your lifetime columnar cells *transform* into squamous cells in this zone.

We all went through puberty and know that change means vulnerability. This is true even on a cellular level — cells are most vulnerable during periods of change. This makes the transformation zone at the cervix the most common place for abnormal cells to develop, which can, but do not always, lead to cancer.


Cervical dysplasia is the growth of abnormal cells on the surface of the cervix. There is a spectrum to dysplasia — an increase in cell abnormality determines where dysplasia is classified on the spectrum (mild to severe). When abnormal cells uncontrollably mobilize beyond the cervical tissue barrier they become cervical cancer.

The number-one risk factor for developing cervical cancer is infection with a high-risk strain of HPV, which sets the stage for the cells to get weird.



Normal cells

What You Need To Know Now

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Human Papillomavirus

Abnormal Pap

Just like a toothbrush, a good nights sleep, and a strong wifi connection, you *need* the HPV vaccine. Swipe right on the vaccine, look right for the details. 

HPV is an *our* problem, not a *her* problem

Sleep is essential!

Sleep is absolutely essential to the body's cellular health. During sleep — especially deep, slow-wave sleep — the body goes to work to repair damaged cells and DNA, promoting healthy new cell growth, fortifying and strengthening the immune system [25].

So your bestie says they were told they only needed a Pap every 5 years but your mom insists it should be yearly? What’s the deal?

 According to the latest guidelines from the American College of Obstetricians and Gynecologists (ACOG), females 21-29 should get a Pap test every 3 years and females 30-65 should get a Pap test and HPV test every 5 years (this is called co-testing), with more frequent testing when results are abnormal. These guidelines are based on both large population data and cost-benefit analysis. In layperson’s terms, this means they are general guidelines. 

At Tia, we believe that no two patients are the same and so the care we provide is individualized and accounts for the factors that make you *you.* Based on a range of factors from sexual behavior to a history of HPV to lifestyle factors that may weaken your immune system, your Care Provider at Tia may recommend more frequent Pap testing.

No one-size-fits-all solutions

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Welcome to the

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Real talk:

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Post-Pap testing

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When cells get weird (read: abnormal)

Did you know? 

There is no exam that tests males for HPV, but they are vectors, meaning they carry and pass the virus. This means vaccinations are key for both males & females!

Heads up.

Pap tests and HPV tests are separate tests, though often conducted at the same time. The vaccine is another way to protect yourself. These 3 are *not* mutually exclusive!  

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Heads up.

Each time you engage with a new sexual partner (or a partner you are not in a monogamous relationship with) you are at risk for being exposed to a new strain of HPV.

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Zooming In On The Cervix

Keep scrolling!

An abnormal Pap does not necessarily mean you have HPV and, if you have HPV, you won’t necessarily get cervical cancer. With screenings, vaccinations, and lifestyle shifts, you have the tools to protect yourself from HPV, abnormal Paps, and cervical cancer!

To clarify:

Not all abnormal cells lead to cancer, but all cancers are abnormal cells.

To clarify:

All cervical cancers were at one time dysplasia, but not all dysplasia becomes cancer.

Want to fact check us? Dig in to our sources!

Heads up.

Abnormal Pap results are on a spectrum. Talk to your provider about where you fall and what kind of follow up testing you need.

Did you know?

Abnormal cells can be removed before they develop into cervical cancer and sometimes the cells will spontaneously revert back to normal on their own.

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1. Arbyn, M., Weiderpass, E., Bruni, L., De Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2019). Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet Global Health.

2. Arnheim-Dahlstrom, L., Pasternak, B., Svanstrom, H., Sparen, P., & Hviid, A. (2013). Autoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: Cohort study. BMJ, 347

3. Benard, V.B., Watson, M., Saraiya, M., Harewood, R., Townsend, J.S., Stroup, A.M., Weir, H.K., & Allemani, C. (2017). Cervical cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer, 123 Suppl 24, 5119-5137 .

4. Cancer Incidence and Mortality Trends Among Whites in the United States, 1947-84, Devesa et al 1987

5. Castellsagué, X. (2008). Natural history and epidemiology of HPV infection and cervical cancer. Gynecologic Oncology, 110(3)

6. Clarke and Anderson, 1979: DOES SCREENING BY "PAP" SMEARS HELP PREVENT CERVICAL CANCER? A Case-control Study, The Lancet

7. Cook, et al, August 2017: A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women's Antioxidant Cardiovascular Study.

8. Dunne, E.F., Unger, E.R., Sternberg, M.R., Mcquillan, G.M., Swan, D., Patel, S.S., & Markowitz, L.E. (2007). Prevalence of HPV infection among females in the United States. JAMA, 297 8, 813-9 .

9. Gardner, J.W., & Lyon, J.L. (1977). Efficacy of cervical cytologic screening in the control of cervical cancer. Preventive medicine, 6 4, 487-99 .

10. Giuliano, A. R., Siegel, E. M., Roe, D. J., Ferreira, S., Luiza Baggio, M., Galan, L., Duarte‐Franco, E., Villa, L. L., Rohan, T. E., Marshall, J. R., & Franco, E. L. (2003). Dietary Intake and Risk of Persistent Human Papillomavirus (HPV) Infection: The Ludwig‐McGill HPV Natural History Study. The Journal of Infectious Diseases, 188(10), 1508–1516. 

11. Grönlund, O., Herweijer, E., Sundström, K., & Arnheim-Dahlström, L. (2016). Incidence of new-onset autoimmune disease in girls and women with pre-existing autoimmune disease after quadrivalent human papillomavirus vaccination: A cohort study. Journal of Internal Medicine, 280(6), 618–626. 

12. Ho, G. Y. F., Bierman, R., Beardsley, L., Chang, C. J., & Burk, R. D. (1998). Natural History of Cervicovaginal Papillomavirus Infection in Young Women. New England Journal of Medicine, 338(7), 423–428. 

13. Hosono, S., Matsuo, K., Kajiyama, H., Hirose, K., Suzuki, T., Kawase, T., Kidokoro, K., Nakanishi, T., Hamajima, N., Kikkawa, F., Tajima, K., & Tanaka, H. (2010). Association between dietary calcium and vitamin D intake and cervical carcinogenesis among Japanese women. European Journal of Clinical Nutrition, 64(4), 400–409. 

14. Klein, N. P., Hansen, J., Chao, C., Velicer, C., Emery, M., Slezak, J., Lewis, N., Deosaransingh, K., Sy, L., Ackerson, B., Cheetham, T. C., Liaw, K.-L., Takhar, H., & Jacobsen, S. J. (2012). Safety of Quadrivalent Human Papillomavirus Vaccine Administered Routinely to Females. Archives of Pediatrics & Adolescent Medicine, 166(12), 1140. 

15. Pirog, E. C., Lloveras, B., Molijn, A., Tous, S., Guimerà, N., Alejo, M., Clavero, O., Klaustermeier, J., Jenkins, D., Quint, W. G., Xavier Bosch, F., Alemany, L., & de Sanjosé, S. (2014). HPV prevalence and genotypes in different histological subtypes of cervical adenocarcinoma, a worldwide analysis of 760 cases. Modern Pathology, 27(12), 1559–1567. 

16. Plummer, M., Herrero, R., Franceschi, S., Meijer, C.J., Snijders, P.J., Bosch, F.X., Sanjosé, S.D., & Muñoz, N. (2003). Smoking and cervical cancer: pooled analysis of the IARC multi-centric case–control study. Cancer Causes & Control, 14, 805-814.

17. Shaw, P. A. (2000). The History of Cervical Screening I: The Pap. Test. Journal SOGC, 22(2), 110–114. 

18. Shim, J., Pérez, A., Symanski, E., & Nyitray, A. G. (2016). Association Between Serum 25-Hydroxyvitamin D Level and Human Papillomavirus Cervicovaginal Infection in Women in the United States. Journal of Infectious Diseases, 213(12), 1886–1892.

19. Smith, J. S., Melendy, A., Rana, R. K., & Pimenta, J. M. (2008). Age-Specific Prevalence of Infection with Human Papillomavirus in Females: A Global Review. Journal of Adolescent Health, 43(4), S5.e1-S5.e62.

20.  Siegel, R.L., Miller, K.D., & Jemal, A. (2019). Cancer statistics, 2019. CA: a cancer journal for clinicians, 69 1, 7-34.

21. Szender, J.B., Cannioto, R., Gulati, N.R., Schmitt, K.L., Friel, G., Minlikeeva, A.N., Platek, A., Gower, E., Nagy, R., Khachatryan, E., Mayor, P.C., Kasza, K.A., Lele, S.B., Odunsi, K., & Moysich, K.B. (2016). Impact of Physical Inactivity on Risk of Developing Cancer of the Uterine Cervix: A Case-Control Study. Journal of lower genital tract disease, 20 3, 230-3 .

22. Tainio, K., Athanasiou, A., Tikkinen, K. A. O., Aaltonen, R., Cárdenas, J., Hernándes, Glazer-Livson, S., Jakobsson, M., Joronen, K., Kiviharju, M., Louvanto, K., Oksjoki, S., Tähtinen, R., Virtanen, S., Nieminen, P., Kyrgiou, M., & Kalliala, I. (2018). Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: Systematic review and meta-analysis. BMJ, k499.

23. Vahedpoor, Z., Jamilian, M., Bahmani, F., Aghadavod, E., Karamali, M., Kashanian, M., & Asemi, Z. (2017). Effects of Long-Term Vitamin D Supplementation on Regression and Metabolic Status of Cervical Intraepithelial Neoplasia: a Randomized, Double-Blind, Placebo-Controlled Trial. Hormones and Cancer, 8, 58-67.

24. Velentzis, L. S., Sitas, F., O’Connell, D. L., Darlington-Brown, J., Egger, S., Sinha, R., Banks, E., Frazer, I. H., & Canfell, K. (2014). Human papillomavirus 16/18 seroprevalence in unvaccinated women over 30 years with normal cytology and with high grade cervical abnormalities in Australia: Results from an observational study. BMC Infectious Diseases, 14(1), 3861.

25. Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams. New York, NY: Simon & Schuster

26. Winkelstein, W. (1990). Smoking and cervical cancer--current status: a review. American journal of epidemiology, 131 6, 945-57; discussion 958-60 .

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Made by

Say sayonara to shame, stigma, and shoddy pamphlets. Say hello to:

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People age 25 and under are at peak risk of contracting cancer-causing HPV. Good news, this age group is also most likely to clear the virus!

sexual partners in your lifetime increases your risk of contracting HPV by 6x!

strains of HPV affect humans but most are not dangerous.

are the most dangerous strains. If you have one of these strains you must be diligent.

of squamous cell cancer, the most common type of cervical cancer, is caused by strains 16 + 18.

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Low-risk 

strains can lead to genital and anal warts.

High-risk

strains can lead to cervical dysplasia and cancer. This includes cervical cancer, anal cancer,  throat cancer, and vulvar cancer.

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Did you know?

Most HPV is wiped out by a healthy immune system within two years.

Heads up.

HPV is transmitted via intercourse, but also through skin-to-skin contact in the genital region.

Its a fact:

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Did you know?

Females over the age of 40 are the group with the fastest rising rates of STI contraction.

Correlation

The extent of the correlation between high-risk HPV and cervical cancer is greater than that between smoking and lung cancer.

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Did you know?

You can get your HPV vaccine at the Tia Clinic. Ready to book? Head to www.asktia.com

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Sleep

Stress

Nutrition

No Smoking

Physical Activity

Vitamin D

To clarify:

The Pap test that everyone loves to hate is largely responsible for the seismic decline in cervical cancer diagnoses and deaths in the U.S.

Heads up.

Worldwide, cervical cancer is still the 4th most diagnosed cancer in females, in the U.S. it doesn't even make the top ten. A major contributing factor in this discrepancy is access and education around prevention, like the Pap test.

Did you know?

Just a century ago, cervical cancer killed more females in the U.S. than any other cancer. This is no longer the case.