Cervical cancer is cancer of the entrance to the uterus (womb). The cervix is the narrow part of the lower uterus, often referred to as the neck of the womb.
The American Cancer Society estimates that 12,990 diagnoses of cervical cancer will be made by the end of 2016 in the United States. Over 4,000 women in the U.S. die from cervical cancer each year.
According to the World Health Organization (WHO), if the HPV vaccine was administered globally, hundreds of thousands of lives could be saved each year.
Since the NHS (National Health Service) Cervical Screening Program began in 1988, the rate of women diagnosed with cervical cancer in the United Kingdom has halved from 16 per 100,000 in 1988 to 8 per 100,000.
Fast facts on cervical cancer
Here are some key points about cervical cancer. More detail and supporting information is in the main article.
- Since cervical screening began in the U.K., cervical cancer rates have halved
- In America, more than 11,000 women are diagnosed with invasive cervical cancer each year
- Having many sexual partners or becoming sexually active early is a risk factor
- Survival rates are good if cervical cancer is caught early
- Symptoms include bleeding between periods and after sex
Causes of cervical cancer
Cancer is the result of the uncontrolled division of abnormal cells. Most of the cells in our body have a set lifespan; when they die, new cells are produced to replace them. Abnormal cells can have two problems:
- They do not die
- They continue dividing
This results in an excessive accumulation of cells which eventually form a lump – a tumor. Scientists are not completely sure why cells become cancerous.
However, there are some risk factors which are known to increase the risk of developing cervical cancer. These risk factors include:
- HPV (human papillomavirus): a sexually transmitted virus. There are over 100 different types of HPVs, at least 13 of which can cause cervical cancer.
- Many sexual partners or becoming sexually active early: Cervical cancer-causing HPV types are nearly always transmitted as a result of sexual contact with an infected individual. Women who have had many sexual partners generally have a higher risk of becoming infected with HPV, which raises their risk of developing cervical cancer.
- Smoking: increases the risk of developing many cancers, including cervical cancer.
- Weakened immune system: such as those with HIV/AIDS, or transplant recipients taking immunosuppressive medications.
- Long-term mental stress: Women who experience high levels of stress over a sustained period may be less able to fight off HPV.
- Giving birth at a very young age: Women who gave birth before the age of 17 are significantly more likely to develop cervical cancer compared with women who had their first baby when they were aged 25 or over.
- Several pregnancies: Women who have had at least three children in separate pregnancies are more likely to develop cervical cancer compared with women who never had children.
- Contraceptive pill: Long-term use of some common contraceptive pills slightly raises a woman’s risk.
- Other sexually transmitted diseases (STD): Women who become infected with chlamydia, gonorrhea, or syphilis have a higher risk of developing cervical cancer.
- Socio-economic status: Studies in several countries have revealed that women in deprived areas have significantly higher rates of cervical cancer.
Symptoms of cervical cancer
Often, during the early stages of cervical cancer, people may experience no symptoms at all. That is why women should have regular cervical smear tests.
The most common symptoms are:
- Bleeding between periods
- Bleeding after sexual intercourse
- Bleeding in post-menopausal women
- Discomfort during sexual intercourse
- Smelly vaginal discharge
- Vaginal discharge tinged with blood
- Pelvic pain
Tests and diagnosis
The earlier cervical cancer is diagnosed, the more successfully it can be treated. Regular cervical screening can save thousands of live every year.
The American College of Obstetricians and Gynecologists advises that the PAP test should be carried out at the same time as the HPV test. The College emphasized that this recommendation is just for women aged 30 years or more.
Cervical screening – LBC or Pap smear test
In the U.S., over 11,000 women are diagnosed with invasive cervical cancer each year and about 4,000 die.
The majority of these deaths could be prevented if all women had undergone cervical screening.
U.S. authorities say a female should start screening at the age of 21, or within 3 years of her first sexual encounter – whichever occurs first.
Cervical screening does not detect cancer, it simply looks for abnormal changes in the cells of the cervix. If left untreated, some abnormal cells can eventually develop into cancer.
HPV DNA test
This test determines whether the patient is infected with any of the HPV types that are most likely to cause cervical cancer. This involves collecting cells from the cervix for lab testing.
The test can detect high-risk HPV strains in cell DNA before any cervix cell abnormalities appear.
If the patient experiences signs and symptoms of cervical cancer, or if the Pap test revealed abnormal cells, the patient might undergo additional tests:
Other tests include:
- Biopsy: A small section of tissue is taken under general anesthetic.
- Colposcopy: A speculum is placed to hold the vagina open as the gynecologist looks at the cervix through a colposcope – a lighted magnifying instrument.
- Cone biopsy: A small cone-shaped section of abnormal tissue is taken from the cervix for examination.
- LLETZ: A diathermy (wire loop with an electric current) is used to remove abnormal tissue. The tissue is sent to the lab to be checked.
- Blood tests: measures number of blood cells, and can identify any liver or kidney problems.
- Examination under anesthetic (EUA): This allows the doctor to examine the vagina and cervix more thoroughly.
- CT scan: The patient consumes a barium drink that appears white on the scan. Just before the scan, a tampon may be placed into the vagina, and a barium liquid may be inserted into the rectum.
- MRI: By using high-MRI with a special vaginal coil, a technique to measure the movement of water within tissue, researchers may be able to identify cervical cancer in its early stages.
- Pelvic ultrasound: This is a device that uses high-frequency sound waves to create an image on a monitor of the target area.