Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.
Most women’s bodies are able to fight HPV infection. But sometimes the virus leads to cancer. You’re at higher risk if you smoke, have had many children, use birth control pills for a long time, or have HIV infection.
Cervical cancer may not cause any symptoms at first. Later, you may have pelvic pain or bleeding from the vagina. It usually takes several years for normal cells in the cervix to turn into cancer cells. Your health care provider can find abnormal cells by doing a Pap test to examine cells from the cervix. You may also have an HPV test. If your results are abnormal, you may need a biopsy or other tests. By getting regular screenings, you can find and treat any problems before they turn into cancer.
Vaccines can protect against several types of HPV, including some that can cause cancer.
Prevention
Cervical cancer can be prevented by doing the following:
- Get the HPV vaccine. The vaccine prevents most types of HPV infection that cause cervical cancer. Your provider can tell you if the vaccine is right for you.
- Practice safer sex. Using condoms during sex reduces the risk for HPV and other sexually transmitted infections (STIs).
- Limit the number of sexual partners you have. Avoid partners who are active in high-risk sexual behaviors.
- Get Pap smears as often as your provider recommends. Pap smears can help detect early changes, which can be treated before they turn into cervical cancer.
- Get the HPV test if recommended by your provider. It can be used along with the Pap test to screen for cervical cancer in women 30 years and older.
- If you smoke, quit. Smoking increases your chance of getting cervical cancer.
Risk Factors
A woman’s sexual habits and patterns can increase her risk of developing cervical cancer.
Risky sexual practices include:
- Having sex at an early age
- Having multiple sexual partners
- Having a partner or many partners who take part in high-risk sexual activities
Other risk factors for cervical cancer include:
- Not getting the HPV vaccine
- Being economically disadvantaged
- Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage
- Having a weakened immune system
Causes
Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears.
Cervical cancer starts in the cells on the surface of the cervix. There are 2 types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells.
Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears, or they have not followed up on abnormal Pap smear results.
Almost all cervical cancers are caused by HPV (human papillomavirus). HPV is a common virus that is spread through sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Others do not cause any problems at all.
Symptoms
Most of the time, early cervical cancer has no symptoms.
Symptoms that may occur include:
- Abnormal vaginal bleeding between periods, after intercourse, or after menopause
- Vaginal discharge that does not stop, and may be pale, watery, pink, brown, bloody, or foul-smelling
- Periods that become heavier and last longer than usual
Cervical cancer may spread to the bladder, intestines, lungs, and liver. Often, there are no problems until the cancer is advanced and has spread.
Symptoms of advanced cervical cancer may include:
- Back pain
- Bone pain or fractures
- Fatigue
- Leaking of urine or feces from the vagina
- Leg pain
- Loss of appetite
- Pelvic pain
- Single swollen leg
- Weight loss
Diagnosis
How well the person does depends on many things, including:
- Type of cervical cancer
- Stage of cancer (how far it has spread)
- Age and general health
- If the cancer comes back after treatment
Precancerous conditions can be completely cured when followed up and treated properly. Most women are alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area. The 5-year survival rate falls as the cancer spreads outside the walls of the cervix into other areas.
Treatment
Treatment of cervical cancer depends on:
- The stage of the cancer
- The size and shape of the tumor
- The woman’s age and general health
- Her desire to have children in the future
Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. This is why routine Pap smears are so important to prevent cervical cancer. There are surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future.
Types of surgery for early cervical cancer include:
- Loop electrosurgical excision procedure (LEEP): Uses electricity to remove abnormal tissue
- Cryotherapy: Freezes abnormal cells
- Laser therapy: Uses light to burn abnormal tissue
A hysterectomy (surgery to remove the uterus but not the ovaries) is not often done for cervical cancer that has not spread. It may be done in women who have had repeated LEEP procedures.
Treatment for more advanced cervical cancer may include:
- Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina.
- Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed.
Radiation may be used to treat cancer that has spread beyond the cervix or cancer that has returned.
Chemotherapy uses drugs to kill cancer. It may be given alone or with surgery or radiation.
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