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Cervical cancer is a preventable disease, thanks in large part to the Pap test. Yet every year in Ontario, about 500 people are diagnosed with cervical cancer. What’s sex got to do with it? How are trans men at risk? Below is some information on cervical cancer and what you can do to prevent it.

What is cervical cancer?

  • Cervical cancer starts in the cells of the cervix. It is a preventable cancer.
  • Your cervix is the narrow end of the uterus which has a small opening (called the os) that connects the uterus with the vagina. If you have had a hysterectomy, you still may have a cervix depending on the type of hysterectomy you had.
  • Cervical cancer usually grows very slowly.
  • Before cervical cancer develops, the cells of the cervix start to change and become abnormal. The name for these precancerous changes to the cervix is cervical dysplasia.
  • Just because you have cervical dysplasia does not mean you have cancer. Sometimes the dysplasia cells go back to normal on their own.
  • Most people with dysplasia do not develop cervical cancer if they follow the recommended guidelines for follow-up.

Cervical cancer, HPV and sex

  • The major cause of cervical cancer is the high risk types of the human papillomavirus (HPV). The virus is mainly transmitted through genital skin-to-skin contact during sexual activity with someone who has the infection.
  • HPV infections are usually cleared up by the immune system on their own over time. However, high risk HPV infections can lead to cervical cancer, which a Pap test can help prevent.
  • Trans men have often been mistakenly told that we are not at risk for HPV but we are at risk.
  • Remember, HPV, the major cause of cervical cancer, is transmitted through genital skin-to-skin contact with anyone who has the infection – this includes oral sex, sex with fingers or hands, genital rubbing and sex with toys.
  • Having HPV doesn’t mean you are going to get cervical cancer, but if you have cervical cancer, it is very likely that HPV is the cause of it.
  • HPV testing is not routinely provided in Ontario, unless you are over 30 and have pap results that show mild cell changes. HPV testing is not recommended for people under 30 because HPV infection is very common in this age group, but it generally goes away on its own. HPV testing is not covered by the Ontario Health Insurance Plan (OHIP). HPV testing guidelines may differ in your province, state, or country. 

Who gets cervical cancer?

  • If you are a trans man and you’ve had sex with men, women, and/or trans people, you can get cervical cancer.
  • Trans guys who have cervixes- of all ages, races, cultures, classes and sexual orientations are at risk of cervical cancer.
  • Cervical cancer usually doesn’t develop until you’re in your 30s or 40s but it can also develop in your 20s.
  • Remember, the biggest cause of cervical cancer is HPV. Most sexually active people, no matter who they have sex with, will get HPV at some point in their lives and never know it.
  • You are at higher risk for cervical cancer if you:
    • Don’t have regular Pap tests
    • Became sexually active at a young age
    • You don’t need to have more than one sexual partner to get HPV, but each time you have a new sexual partner, your risk of getting HPV rises.
    • Smoke or have exposure to second hand smoke
    • Have an immune system suppressing condition such as HIV/AIDS
  • Having any of these risk factors doesn’t mean you will develop cervical cancer. It just means that your chances of developing it are higher.

How can I prevent cervical cancer?

  • Get regular Pap tests. Remember: most cases of cervical cancer occur in people who have not been getting regular Pap tests. Click here to find out how often you should get a Pap test.
  • Encourage your sexual partners who have a cervix to get regular Pap tests too.
  • The best way to prevent cervical cancer is to prevent HPV. There is no way of completely preventing HPV infection but there are some things you can do to reduce your risk:
  • Use condoms on sex toys, dildos and penises, dental dams or condoms cut up one side for oral sex and latex gloves for finger play. Because HPV is transmitted by genital skin to skin contact, these barriers do not fully protect you from HPV. They can, however, significantly reduce your risk.
  • Take care of your sex toys. Clean all toys according to the manufacturer’s instructions.
    Considering the HPV vaccine, called Gardasil. It prevents against four common strains of HPV, 2 of which can lead to cervical cancer. It is a series of 3 shots over a 6 month period. It is not covered by OHIP but is covered by over 50% of insurance plans. It costs about $135 per dose (almost $500 total). It is currently recommended for girls 9-26 years of age, but can offer protection outside of that age range and for trans men. Talk to your family doctor or local sexual health/public health clinic.
  • Remember that even if you get the vaccine, you still need annual Pap tests.
  • You don’t need to have more than one sexual partner to get HPV, but each time you have a new sexual partner, your risk of getting HPV rises.
  • Talk to your sexual partners about HPV. While HPV is difficult to prevent and disclosing that you’ve had HPV can be difficult, open and honest communication can help you decide about safer sex practices together.
  • Smoking tobacco and breathing second-hand smoke can make mild cell changes on your cervix progress to cancer. Try to quit smoking or smoke less.
  • Take care of yourself. Eat a diet full of fruits and vegetables, whole grains, protein and limited sugar and trans fats. Exercise regularly, do your best to manage stress and get enough rest to stay healthy and keep your immune system strong.
  • Pay attention to your body and report any changes to your doctor. Change doesn’t necessarily mean you have a serious health problem, but it’s important to get any of the following symptoms checked out: abnormal bleeding; more discharge than normal, pain in the pelvis or lower back or pain during penetration.

Should I get a pap test?

Frequently Asked Questions about Paps

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