Cervical cancer affects the entrance to the womb. The cervix is the narrow part of the lower uterus, often referred to as the neck of the womb. Human papillomavirus (HPV) causes the majority of cervical cancer cases. The HPV vaccine successfully prevents HPV.
Cervical cancer is a type of cancer that occurs in the cells of the cervix i.e. the lower part of the uterus that connects to the vagina. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer. When exposed to HPV, the body's immune system typically prevents the virus from doing harm. In some people, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells. You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.
What is Cervical Cancer?
Cervical cancer occurs when the cells of the cervix grow abnormally and invade other tissues and organs of the body. When it is invasive, this cancer affects the deeper tissues of the cervix and may have spread to other parts of the body, mostly the lungs, liver, bladder, vagina, and rectum. However, cervical cancer is slow-growing, so its progression through precancerous changes provides opportunities for prevention, early detection, and treatment. Better means of detection have meant a decline in cervical cancer.
Most women diagnosed with precancerous changes in the cervix are in their 20s and 30s, but the average age of women when they are diagnosed with cervical cancer is the mid-50s. This difference in the age at which precancerous changes are most frequently diagnosed and the age at which cancer is diagnosed highlights the slow progression of this disease and the reason why it can be prevented if adequate steps are taken.
Types of Cervical Cancer
The type of cervical cancer that helps determine your prognosis and treatment are:
- Squamous cell carcinoma - This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
- Adenocarcinoma - This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.
Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.
Causes of Cervical Cancer
Human papillomavirus (HPV) is found in about 99% of cervical cancers. There are over 100 different types of HPV, most of which are considered low-risk and do not cause cervical cancer. High-risk HPV types may cause cervical cell abnormalities or cancer. More than 70 percent of cervical cancer cases can be attributed to two types of the virus, HPV-16 and HPV-18, often referred to as high-risk HPV types.
HPV is estimated to be the most common sexually transmitted infection. In fact, by age 50 approx. 80 percent of women have been infected with some type of HPV. The majority of women infected with the HPV virus do not develop cervical cancer. For most women the HPV infection does not last long; 90% of HPV infections resolve on their own within 2 years. A small number of women do not clear the HPV virus and are considered to have persistent infection. A woman with a persistent HPV infection is at greater risk of developing cervical cell abnormalities and cancer than a woman whose infection resolves on its own. Certain types of this virus are able to transform normal cervical cells into abnormal ones. In some cases and usually over a long period of time, some of these abnormal cells may then develop into cervical cancer.
Factors that increase the risk of cervical cancer
Some risk factors might increase the risk of developing cervical cancer. These include:
- HPV - This is a sexually transmitted virus. More than 100 different types of HPV can occur, at least 13 of which may cause cervical cancer.
- Having many sexual partners - The transmission of cancer-causing HPV types nearly always occur as a result of sexual contact with an individual who has HPV. Women who have had many sexual partners generally have a higher risk of HPV infection. This increases their risk of developing cervical cancer.
- Smoking - This increases the risk of cervical cancer.
- Weakened immune system - The risk of cervical cancer is higher in those with HIV or AIDS, and people who have undergone a transplant, leading to the use of immunosuppressive medications.
- Birth control pills - Long-term use of some common contraceptive pills slightly raises a woman's risk.
- Other sexually transmitted diseases (STD) - Chlamydia, gonorrhea, and syphilis increase the risk of developing cervical cancer.
- Socio-economic status - Rates appear to be higher in areas where income are low.
- Age - People younger than 20 years old rarely develop cervical cancer. The risk goes up between the late teens and mid-30s. Women past this age group remain at risk and need to have regular cervical cancer screenings, which include a Pap test and/or an HPV test.
- Exposure to diethylstilbestrol (DES) - Women whose mothers were given this drug during pregnancy to prevent miscarriage have an increased risk of developing a rare type of cancer of the cervix or vagina. DES was given for this purpose from about 1940 to 1970. Women exposed to DES should have an annual pelvic examination that includes a cervical Pap test as well as a 4-quadrant Pap test, in which samples of cells are taken from all sides of the vagina to check for abnormal cells.
Symptoms of Cervical Cancer
If left untreated, precancerous symptoms may progress to cervical cancer, but this progression usually takes 10-20 years. Women may think the symptoms are related to something else, such as their menstrual cycle, a yeast infection, or a urinary tract infection. Symptoms of early-stage cervical cancer may include:
• irregular bleeding i.e. between periods or after sexual intercourse or after a pelvic exam, or after menopause
• postmenopausal spotting or bleeding;
• increased vaginal discharge, sometimes foul-smelling;
• More severe symptoms may arise at advanced stages.
• urinating more frequently
• pelvic pain
• painful urination
Abnormal bleeding doesn't mean you have cervical cancer. All women should have regular cervical cancer screenings. Also, if you experience these symptoms, talk to your doctor about screening for cervical cancer.
Preventive measures for Cervical Cancer
To reduce your risk of cervical cancer:
• Ask your doctor about the HPV vaccine - Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your doctor whether an HPV vaccine is appropriate for you.
• Have routine Pap tests - Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer. Several medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.
• Practice safe sex - Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.
• Don't smoke - If you don't smoke, don't start. If you do smoke, talk to your doctor about strategies to help you quit immediately.
Treatment for Cervical Cancer
Cervical cancer treatment options include surgery, radiotherapy, chemotherapy, or combinations of these. Deciding on the kind of treatment depends on several factors, such as the stage of the cancer, as well as age and overall state of health. Treatment for early-stage cervical cancer, when the cancer remains within the cervix, has a good success rate. The further a cancer spreads from its original area, the lower the success rate tends to be.
At an early stage, surgery is a common treatment method when the cancer has not spread from the cervix. Radiation therapy may help after surgery if a doctor believes that cancer cells might be present inside the body. Radiation therapy may also reduce the risk of recurrence. If the surgeon wants to shrink the tumor to make it easier to operate, the person may receive chemotherapy.
At an advanced stage, when the cancer has spread beyond the cervix, surgery is not usually an option. Doctors also refer to advanced cancer as invasive cancer, because it has invaded other areas of the body. This type of cancer requires more extensive treatment, which will typically involve either radiation therapy or a combination of radiation therapy and chemotherapy. In the later stages of cancer, healthcare professionals provide palliative therapy to relieve symptoms and improve quality of life.
Radiation Therapy - Some doctors refer to radiation therapy as radiation oncology or XRT. It involves the use of beams of high-energy X-rays or radiation to destroy cancer cells. When the treating doctor aims radiation at the pelvic area, it may cause the following side effects, some of which may not emerge until after the treatment is over:
• upset stomach
• bladder irritation
• narrowing of the vagina
• interrupted menstrual cycle
• early menopause
Chemotherapy - Chemotherapy is the use of chemicals to treat any disease. In this context, it refers to the destruction of cancer cells. Doctors use chemotherapy to target cancer cells that surgery cannot or did not remove, or to help the symptoms of people with advanced cancer. The side effects of chemotherapy can vary, and they depend on the specific drug. Common effects include:
• hair loss
• early menopause
When it’s detected in its earliest stages, cervical cancer is considered one of the most treatable cancer types. According to various surveys, deaths from cervical cancer have declined with increased screening through Pap tests. Getting regular Pap tests to check for precancerous cells is thought to be one of the most important and effective means of prevention. Getting vaccinated against HPV and undergoing regular Pap test screenings can help you reduce your risk for cervical cancer.