Cervical cancer is cancer that starts in a woman's cervix. The cervix is the opening of the uterus. It connects the vagina (or birth canal) to the uterus (womb). Cervical cancer usually starts with changes to the cells on the cervix, called dysplasia. These abnormal cells can be removed to prevent cancer if found early.
There are two main types of cervical cancer:
- Squamous cell – eight out of 10 (80%) cervical cancers are diagnosed as squamous cell. Squamous cell cancers are composed of the flat cells that cover the surface of the cervix and often begin where the outer surface joins with the cervical canal
- Adenocarcinoma – more than one in 10 (15–20%) cervical cancers are diagnosed as adenocarcinoma. This cancer develops in the glandular cells which line the cervical canal. This type of cancer can be more difficult to detect with cervical screening tests because it develops within the cervical canal.
Adenosquamous cancers are tumours that contain both squamous and glandular cancer cells.
Other rare types of cervical cancer can include clear cell, small cell neuroendocrine carcinomas, lymphomas and sarcomas.
It often takes several years for cervical cancer to develop. During this time, the cells on or around the cervix become abnormal. The early cell changes that occur before cancer is present are called dysplasia
or cervical intraepithelial neoplasia (CIN)
The most important risk factor for cervical cancer is infection with the types of HPV linked to cancer. The following factors increase your risk of becoming infected with HPV:
- Multiple sexual partners
- Having a male sexual partner who has had multiple sexual partners
- Early age at which you first had sex (younger than 18 years)
Other risk factors include the following:
- A personal history of dysplasia of the cervix, vagina, or vulva
- A family history of cervical cancer
- Certain sexually transmitted infections, such as chlamydia
- Problems with the immune system
- Having a mother who took a drug called diethylstilbestrol (DES) during pregnancy
In the early stages of cervical cancer, there are often no symptoms. The longer a woman has cervical cancer without treatment, the more likely she will have symptoms. Some of the symptoms of later stage cervical cancer can include:
- Heavy vaginal bleeding or discharge (more than usual)
- Bleeding after sex, between periods or after a pelvic exam
- Pain during sex or urination
If you have any of these symptoms, talk to your health care provider. These symptoms may be caused by something else, but the only way to know for sure is
to see your health care provider.
A risk factor is anything that increases the chance of getting a disease. Any woman can get cervical cancer, but some women are at higher risk because of factors such as:
- Having the Human Papillomavirus Virus (HPV)
HPV causes nearly all cases of cervical cancer. It is the most common sexually transmitted infection in the United States. Both men and women can have HPV.
HPV often goes away on its own, but if it does not, it could cause cervical cancer in women. Many women will have an HPV infection at some point in their lives, but few will get cervical cancer.
- Not Getting Screened
Cervical cancer is most often found in women who have not been screened with the Pap (Papanicolaou) test in more than five years or who have never been screened at all. Women who have been screened but do not follow up with their health care provider when results are abnormal are also more likely to develop cervical cancer.
- Smoking:- Women who smoke are about two times more likely to get cervical cancer, compared to women who do not smoke.
- Aging:- Women over the age of 30 are more likely to get cervical cancer.
Other risk factors for cervical cancer include:
- Having been treated before for cervical cancer or for abnormal cells that may become cancer
- Using birth control pills for five years or longer
- Giving birth three or more times
- Having multiple sexual partners
- Having HIV, or another condition that makes it hard for your body to fight off infections
- Having a mother who took DES (diethylstilbestrol) while pregnant with you.
Cervical cancer is not caused by genetic changes that can be passed down through families, so is not thought to be hereditary.
Cervical cancer is not infectious and cannot be passed on to other people.
Some risk factors, like age, cannot be controlled, but others can. Some ways to lower the risk of cervical cancer or prevent it entirely are:
- The HPV vaccine protects against the types of HPV that most often cause cervical cancer. It is recommended for both males and females.
- In females, the HPV vaccine helps to prevent cervical, ovarian, uterine, vaginal and vulvar cancers. It also protects against cancer of the anus, mouth and throat.
- In males, the HPV vaccine helps to prevent cancer of the penis, anus, mouth and throat.
Cervical cancer can be prevented or found early with regular screening tests.
There are two screening tests that can help prevent cervical cancer or find it early:
- Pap test (or Pap Smear):- A Pap test looks for changes in cells taken from the cervix and sent to a lab to be looked at under a microscope. It is most often done during a routine pelvic exam. If the Pap test shows cells that are not normal and may become cancer, your health care provider will contact you. There are many reasons why Pap test results may be abnormal. It usually does not mean you have cancer. Deaths from cervical cancer have gone down by more than 50% over the past 40 years mostly due to the (Pap) test.
- High Risk (HR) HPV test:- The HR HPV test looks for types of HPV that cause most cases of cervical cancer. The HPV test can be done at the same time as the Pap test. A positive result for HR HPV means that your health care provider should follow up with you often to make sure that abnormal cells do not develop.
Many people confuse pelvic exams with Pap tests because they are usually done at the same time. During a pelvic exam, the health care provider feels the reproductive organs. The pelvic exam may help find diseases of the female organs, but it will not find cervical cancer at an early stage. To do that, a screening test is needed.
Worldwide, cervical cancer is the second-most-common type of cancer that strikes women – behind only breast cancer. In the United States, cervical cancer is the 14th most common cause of new cancers diagnosed among women every year. The American Cancer Society estimates that in 2007, about 11,150 women in the United States developed cervical cancer and about 3,700 died from it. That lower occurrence of cervical cancer in the United States is largely thanks to the Pap test, which has helped decrease the number of American women with cervical cancer by about 75 percent in the past 50 years.
The prognosis (chance of recovery) depends on factors such as:
- The stage of cancer (whether it affects part of the cervix, involves the whole cervix or has spread to the lymph nodes or other places in the body).
- The size of the tumour.