Women's Health
FAQ508, December 2018


In October 2018, the U.S. Food and Drug Administration (FDA) approved the human papillomavirus (HPV) vaccine for people aged 27–45 years. The vaccine was already approved for people aged 9–26 years. Experts are now discussing how and when the vaccine should be offered to adults. In the meantime, if you are older than 26 years and interested in getting the HPV vaccine, talk with your health care professional. The vaccine is safe and effective in preventing new HPV infections in people aged 27–45 years.


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Reducing Your Risk of Cancer: Lifestyle Changes and Screening Tests

What is cancer?

Normal cells in the body grow, divide, and are replaced on a routine basis. Sometimes, cells divide abnormally and begin to grow out of control. These cells may form growths or tumors.

Tumors can be benign (not cancer) or malignant (cancer). Benign tumors do not spread to other body tissues. Cancer tumors can invade and destroy nearby healthy tissues and organs. Cancer cells also can spread to other parts of the body and form new cancerous areas.

What are the warning signs of cancer?

Certain changes in your body may be signs of cancer:

  • A change in bowel or bladder habits
  • A sore that does not heal
  • Unusual bleeding or discharge
  • Thickening or a lump in the breast or other parts of the body
  • Skin changes, including a wart or mole that changes in color or size
  • Indigestion or trouble swallowing
  • A nagging cough or hoarseness
  • Unexplained weight loss
  • Extreme tiredness (fatigue) even after sleep

These are not always signs of cancer, but they can be clues that something is wrong. If you notice something different in how your body looks or feels, contact your health care professional.

How can I reduce my overall risk of cancer?

The following lifestyle changes may reduce your risk of cancer:

  • Do not smoke.
  • Limit your time in the sun, use sunscreen, and do not use tanning beds.
  • Limit how much alcohol you drink to no more than one drink per day.
  • Limit your number of sexual partners.
  • Stay at a healthy weight. The body mass index (BMI) is a tool that often is used to measure body fat based on height and weight. To find out your BMI, you can use the online calculator at www.nhlbi.nih.gov/health/educational/
    lose_wt/BMI/bmicalc.htm
    . A person with a BMI of 18.5–24.9 is at a normal weight.
  • Maintain a healthy diet. Limit how much processed and red meat you eat. Have at least 2–3 cups of fruits and vegetables daily. Choose brown rice and whole wheat bread instead of white rice and white bread.
  • Exercise regularly. Get 150 minutes of moderate exercise or 75 minutes of intense exercise per week.
  • Get cancer screening tests and vaccines as recommended for your age group and health history.

What types of cancer should women be aware of?

There are many types of cancer. Some common types of cancer in women include the following:

  • Breast
  • Lung
  • Colon
  • Endometrium (lining of the uterus)
  • Skin
  • Ovary
  • Cervix
  • Vulva

How can I reduce my risk of breast cancer?

The main risk factors for breast cancer—being a woman and getting older—cannot be controlled. But there are some things you can do that may lower your risk of breast cancer:

  • Stay at a healthy weight. A person with a BMI of 18.5–24.9 is at a normal weight.
  • Exercise regularly. Get 150 minutes of moderate exercise or 75 minutes of intense exercise per week.
  • Limit or avoid alcohol.
  • Breastfeed.

It also is important to have mammography, which screens for breast cancer. Finding breast cancer early makes it easier to treat. Women at average risk of breast cancer should be offered mammography starting at age 40 years. If you have not started screening in your 40s, you should begin having mammography no later than age 50 years. Screening should be done every 1–2 years until at least age 75 years. Women at high risk of breast cancer, such as those with BRCA1 and BRCA2 gene mutations, may need to have more frequent screening. You and your obstetrician–gynecologist (ob-gyn) or other health care professional should talk together about what age to begin screening (see FAQ178 Mammography and Other Screening Tests for Breast Problems).

How can I reduce my risk of lung cancer?

Most cases of lung cancer are caused by smoking cigarettes. The best way to protect yourself from lung cancer is to not smoke. As soon as you stop smoking, your risk will begin to decrease. You also should avoid being around people who are smoking.

If you smoke, ask your health care professional for advice on how to quit or call 1-800-QUIT-NOW. This national network for quitting smoking will connect you to counselors in your state. These counselors can offer resources and advice about quitting.

Women aged 55–80 years with a history of smoking should ask their health care professional about annual screening for lung cancer. Screening is recommended for women who are currently heavy smokers or who have quit within the past
15 years.

How can I reduce my risk of colon cancer?

Colon cancer often begins as a polyp. Routine screenings can help detect polyps before they become cancer. Removing precancerous polyps can prevent colon cancer. The American Cancer Society recommends getting a colon cancer screening test starting at age 45 years. These tests may include the following:

Tests that look through the colon with a telescope

  • Colonoscopy
  • Sigmoidoscopy

X-ray tests

  • Virtual colonoscopy

Tests that examine stool for blood or abnormal genetic material

  • Fecal occult blood test
  • DNA stool test

Talk with your health care professional about which screening test is right for you. Limiting how much processed and red meat you eat and having at least 2–3 cups of fruits and vegetables daily also may reduce your risk of colon cancer.

How can I reduce my risk of cancer of the uterus?

Cancer of the lining of the uterus is called endometrial cancer. It is not possible to prevent most cases of this cancer. But there are a few steps you can take that may reduce your risk. These include:

  • Stay at a healthy weight. A person with a BMI of 18.5–24.9 is at a normal weight.
  • Exercise regularly. Get 150 minutes of moderate exercise or 75 minutes of intense exercise per week.
  • Get treated for any endometrial problems before they become cancer. Symptoms of endometrial problems can include spotting or bleeding outside of your menstrual period or after menopause. Treatments may include birth control pills, progestin pills or injection, an intrauterine device (IUD) that releases progestin, or a vaginal progesterone cream.
  • Talk with your doctor if you have a strong family history of cancer. A genetic condition known as Lynch syndrome may increase your risk of endometrial cancer and other types of cancer.

How can I reduce my risk of skin cancer?

You can reduce your risk of skin cancer by taking the following steps:

  • Avoid being out in the sun, especially between 10 am and 4 pm daylight saving time (9 am to 3 pm standard time).
  • Use sunscreen that has both UVA and UVB protection and a sun protection factor (SPF) of at least 30.
  • Wear sunglasses that block UV rays, clothing that covers your arms and legs, and hats that shade your head and neck.
  • Do not use tanning beds or sun lamps.
  • Watch the moles and spots on your skin. Tell your health care professional if you notice any changes. Ask for a skin exam during your regular check-ups.

How can I reduce my risk of cancer of the ovary?

Ovarian cancer is hard to detect, so women should be aware of changes in their bodies. See your health care professional if you have any of these symptoms for more than a few weeks:

  • Abdominal swelling or pain
  • Pelvic pain
  • Difficulty eating or feeling full quickly

There are some things you can do that may reduce your risk.

Birth Control Pills. Using birth control pills lowers the risk of ovarian cancer. The benefit is greater if you have used the pill for several years. Talk with your health care professional about the possible benefits and risks of taking birth control pills.

Surgery. Women at high risk of ovarian cancer may consider surgery to remove the ovaries and fallopian tubes. This surgery may reduce the risk of cancer. Women at high risk include those with a history of ovarian cancer, BRCA1 and BRCA2 gene mutations, or Lynch syndrome. The timing of surgery may depend on your desire to have children in the future. Women at average risk of ovarian cancer also may consider surgery to remove the fallopian tubes, if they are already having abdominal surgery for another reason.

How can I reduce my risk of cancer of the cervix?

You can reduce your risk of cervical cancer by taking the following steps:

  • Get Pap tests. Pap tests can find cervical problems early, before they become cancer. Women aged 21-29 years should have a Pap test every 3 years. Women aged 30–65 years should have a Pap test and a human papillomavirus (HPV) test every 5 years.
  • Get vaccinated. The HPV vaccine is given as a series of shots and protects against the HPV types that are the most common cause of cancer, precancer, and genital warts. The ideal age for HPV vaccination is age 11 years or 12 years, but anyone can be vaccinated from age 9–26 years. See FAQ191 Human Papillomavirus (HPV) Vaccination for details.
  • Do not smoke.
  • Use condoms. Condoms help prevent HPV infection, but they do not give full protection.

How can I reduce my risk of cancer of the vulva?

There is no screening for cancer of the vulva, so be aware of common symptoms. These include itching, burning, or abnormal skin that may be bumpy, smooth, or a different color like white, brown, or red. Precancerous changes to vulvar skin often are caused by HPV infection. You can reduce your risk of cancer of the vulva by taking the following steps:

  • Get the HPV vaccine through age 26 years if you were not vaccinated as a child or teen.
  • Do not smoke.

Glossary

BRCA1 and BRCA2: Genes that keep cells from growing too rapidly. Changes in these genes have been linked to an increased risk of breast cancer and ovarian cancer.

Cervix: The lower, narrow end of the uterus at the top of the vagina.

Colonoscopy: An exam of the large intestine using a small, lighted instrument.

Endometrium: The lining of the uterus.

Endometrial Cancer: Cancer of the lining of the uterus.

Estrogen: A female hormone produced in the ovaries.

Fallopian Tubes: Tubes through which an egg travels from the ovary to the uterus.

Fecal occult blood test: A test in which a sample of stool is tested for blood, which could be a sign of cancer of the colon or rectum.

Human Papillomavirus (HPV): The name for a group of related viruses, some of which cause genital warts and some of which are linked to cancer of the cervix, vulva, vagina, penis, anus, mouth, and throat.

Mammography: X-rays of the breast that are used to find breast cancer or other breast problems.

Menopause: The time when a woman’s menstrual periods stop permanently. Menopause is confirmed after 1 year of no periods.

Mutations: Changes in a gene that can be passed from parent to child.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.

Ovary: An organ in women that contains the eggs necessary to get pregnant and makes important hormones, such as estrogen, progesterone, and testosterone.

Pap Test: A test in which cells are taken from the cervix (or vagina) to look for signs of cancer.

Polyp: An abnormal tissue growth that can develop on the inside of an organ.

Progestin: A synthetic form of progesterone that is similar to the hormone made naturally by the body.

Progesterone: A female hormone that is made in the ovaries and prepares the lining of the uterus for pregnancy.

Screening Tests: Tests that look for possible signs of disease in people who do not have signs or symptoms.

Sigmoidoscopy: A test in which a slender device is placed into the rectum and lower colon to look for cancer.

Uterus: A muscular organ in the female pelvis. During pregnancy this organ holds and nourishes the fetus.

Vulva: The external female genital area.

If you have further questions, contact your obstetrician–gynecologist.

FAQ508: This information was designed as an educational aid to patients and sets forth current information and opinions related to women’s health. It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care. It is not a substitute for a treating clinician’s independent professional judgment. Please check for updates at www.acog.org to ensure accuracy.

Copyright December 2018 by the American College of Obstetricians and Gynecologists

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998