The American Cancer Society estimates that 12,280 diagnoses of cervical cancer will be made by the end of 2017 in the United States. More than 4,000 women in the U.S. will die from cervical cancer this year.
The majority of cervical cancer cases are caused by HPV (human papillomavirus). The HPV vaccine successfully prevents HPV and the Centers for Disease Control and Prevention (CDC) recommend the vaccine for all preteens.
Currently, only one third of American teens are vaccinated. CDC Director, Dr. Tom Frieden, says:
"50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if we reach 80 percent vaccination rates."
Since the United Kingdom's NHS (National Health Service) Cervical Screening Program began in 1988, the rate of women diagnosed with cervical cancer in the U.K. has halved from 16 per 100,000 in 1988 to 8 per 100,000.
Here are some key points about cervical cancer. More detail and supporting information is in the main article.
- 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.
Cervical cancer symptoms
In the early stages of cervical cancer, a person may experience no symptoms at all. As a result, women should have regular cervical smear tests.
The most common symptoms of cervical cancer 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
These symptoms can have other causes, including infection. Anyone who experiences any of these symptoms should see a doctor.
Causes of cervical cancer
The majority of cervical cancer cases are caused by HPV.
Cancer is the result of the uncontrolled division and growth of abnormal cells. Most of the cells in our body have a set lifespan and 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 forms a lump, otherwise known as a tumor. Scientists are not completely sure why cells become cancerous.
However, there are some risk factors that are known to increase the risk of developing cervical cancer. These risk factors include:
HPV (human papillomavirus) - a sexually transmitted virus. There are more than 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.
A weakened immune system - such as in people with 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. A study from the American Academy of Pediatrics in 2016 supported this. Principal investigator Dr. Anna-Barbara Moscicki said: "Women who reported self-destructive coping strategies, like drinking, smoking cigarettes or taking drugs when stressed, were more likely to develop an active HPV infection."
Giving birth at a very young age - women who give birth before the age of 17 are significantly more likely to develop cervical cancer compared with women who have their first baby after the age of 25.
Several pregnancies - women who have had at least three children in separate pregnancies are more likely to develop cervical cancer compared to women who have never had children.
Contraceptive pill - long-term use of some common contraceptive pills slightly raises a woman's risk.
Socio-economic status - studies in several countries have revealed that women in deprived areas have significantly higher rates of cervical cancer.
Cervical cancer treatments
Deciding on the kind of treatment depends on several factors, such as the stage of the cancer, as well as the patient's age and state of health.
Treatment for early stage cervical cancer - cancer that is confined to the cervix - has a good success rate. The further the cancer has spread out of the area it originated from, the lower the success rate tends to be.
Early stage cervical cancer treatment options
Surgery is commonly used when the cancer is confined to the cervix. Radiotherapy may be used after surgery if a doctor believes there may still be cancer cells inside the body.
Radiotherapy may also be used to reduce the risk of recurrence (cancer coming back). If the surgeon wants to shrink the tumor to make it easier to operate, the person may receive chemotherapy although this is not a very common approach.
Treatment for advanced cervical cancer
When the cancer has spread beyond the cervix, surgery is not usually an option.
Advanced cancer is also referred to as invasive cancer because it has invaded other areas of the body. This type of cancer requires more extensive treatment and a person will typically be treated with either radiotherapy or a combination of radiotherapy and chemotherapy.
In the later stages of cancer, palliative therapy is administered to relieve symptoms and improve quality of life.
Radiotherapy is commonly used to treat advanced forms of cervical cancer. Around 40% of all cancer patients undergo some form of radiotherapy.
Radiotherapy is also known as radiation therapy, radiation oncology, and XRT. It involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiation that is aimed at the pelvic area 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 is the use of chemicals (medication) to treat any disease. In this context, it refers to the destruction of cancer cells.
Chemotherapy for cervical cancer, as with most other cancers, is used to target cancer cells that surgery cannot or did not remove, or to help the symptoms of people with advanced cancer.
Side effects of chemotherapy can vary, and they depend on the specific drug being used. Below is a list of the more common side effects:
Cervical cancer clinical trials
Participating in a clinical trial may be the best treatment option for some people. Many of the current treatments that are available are the results of clinical trials.
Clinical trials are an integral part of the cancer research process. They are done to determine how safe and effective new treatments are, and whether they are better than existing ones. People who participate in clinical trials are contributing to cancer research and innovation.
Prevention of cervical cancer
There are a number of measures that can be taken to reduce the chances of developing cervical cancer.
Human papillomavirus (HPV) vaccine
The link between the development of cervical cancer and some types of HPV is clear. If every female adheres to current HPV vaccination programs, cervical cancer could potentially be reduced.
Safe sex and cervical cancer
The HPV vaccine only protects against two HPV strains. There are other strains which can cause cervical cancer. Using a condom during sex helps protect from HPV infection.
Regular cervical screening will make it much more likely that signs of cancer are picked up early and dealt with before the condition can develop, or spread too far. Screening does not detect cancer but detects changes to the cells of the cervix.
Having fewer sexual partners
The more sexual partners a woman has, the higher the risk of transmitting the HPV virus, which can lead to a higher likelihood of developing cervical cancer.
Delaying first sexual intercourse
The younger a female is when she has her first sexual intercourse, the higher the risk of HPV infection. The longer she delays it, the lower her risk.
Women who smoke and are infected with HPV have a higher risk of developing cervical cancer than people who do not.
Cervical cancer diagnosis and tests
Experts believe that the majority of deaths from cervical cancer would be prevented if all women underwent cervical screening as recommended.
The earlier cervical cancer is diagnosed, the more successful treatment for it can be.
Regular cervical screening can save thousands of lives every year.
The American College of Obstetricians and Gynecologists advises that the Pap test for early detection of cancer of the uterus and cervix 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 smear test
In the U.S. more than 11,000 women are diagnosed with invasive cervical cancer each year, and about 4,000 die of it.
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. As said previously, cervical screening does not detect cancer but looks for abnormal changes in the cells of the cervix. If left untreated, some abnormal cells can eventually develop into cancer.
HPV DNA testing
This test determines whether the patient is infected with any of the HPV types that are the most likely to cause cervical cancer. It 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 a person experiences signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells, they might then undergo additional tests including:
- Biopsy - a small section of tissue is taken under general anesthesia.
- 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 - small cone-shaped section of abnormal tissue is taken from the cervix for examination.
- LLETZ - 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 - measure the number of blood cells, and can identify any liver or kidney problems.
- Examination under anesthesia (EUA) - this allows the doctor to examine the vagina and cervix more thoroughly.
- CT scan - a person consumes a barium drink that appears white on the scan. Just before the scan, a tampon can 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 method that uses high-frequency sound waves to create an image of the target area on a monitor.