A cancerous growth occurring in the lower end of the cervix
- Most common between the ages of 45 and 65
- Unprotected sex at an early age, unprotected sex with multiple partners, and smoking are risk factors
- Genetics is not a significant factor
Cervical cancer is the 12th most common cancer in women, with about 2,900 new cases being diagnosed in the UK in 2006. It is one of the few cancers that can be largely prevented by regular screening before symptoms appear. The HPV (human papillomavirus) vaccine also helps to protect against the disease.
Cancer of the cervix usually develops slowly. In the precancerous stage, cervical cells gradually change from being mildly to extremely abnormal, a condition known as cervical intraepithelial neoplasia. These changes in the cervical cells can be detected using a cervical smear test, allowing treatment to be carried out before cancer develops.
What are the causes?
The cause of cervical cancer is not clear in all cases but in some cases it is associated with certain strains of the human papillomavirus (HPV). This virus is transmitted through unprotected sexual intercourse, and the risk of cervical cancer is increased if you have unprotected sex from an early age or with many partners. Smoking is also a risk factor for cervical cancer. Women who have reduced immunity or who are taking immunosuppressants are at increased risk of developing cancer of the cervix.
What are the symptoms?
Cancer of the cervix does not always cause symptoms. However, in some women, there may be some abnormal vaginal bleeding, especially after sexual intercourse. As the cancer progresses, further symptoms may include:
A watery, bloodstained, and offensive-smelling vaginal discharge.
Left untreated, cancer of the cervix may spread to the uterus and then to the lymph glands in the pelvis. Eventually, cancer may spread to other parts of the body, such as the liver and lungs.
How is it diagnosed?
If your doctor suspects that you have cancer of the cervix from your symptoms, he or she may perform a smear test and should arrange for you to have a colposcopy, in which the cervix is viewed through a magnifying instrument and checked for abnormal areas. A sample of tissue will probably be taken from the cervix during the procedure and later examined under a microscope for evidence of cancerous cells.
If cancer of the cervix is diagnosed, you may have further tests to see if the condition has spread to other parts of the body. These tests may include a chest X-ray or MRI of the chest to look at the lungs and blood tests and CT scanning of the abdomen to assess liver function.
What is the treatment?
The treatment for cancer of the cervix depends on the stage of the disease and your individual circumstances.
If the cancer is confined to the cervix and you plan to have children, it may be possible to remove only the affected area of the cervix. If the disease has spread to the uterus and pelvis, it may be necessary to remove the uterus as well as the fallopian tubes, the ovaries, the top of the vagina, and the nearby lymph nodes. In women who are premenopausal, the ovaries are left if possible because they produce sex hormones and removing them causes premature menopause. If the cancer has spread to other organs in the body, radiotherapy, and sometimes chemotherapy, may be needed.
What is the prognosis?
If cervical cancer is diagnosed and treated early, most women recover completely. However, if the disease has spread, it can be fatal; in 2007 more than 900 women in the UK died from cervical cancer.
Can it be prevented?
Routine cervical smear tests can help to ensure the early diagnosis and treatment of abnormal cervical cells and have greatly reduced the incidence of cervical cancer. In addition to having regular cervical smears, it is advisable to try to reduce the risk of developing cervical cancer by not smoking and by using barrier methods of contraception.
A vaccine is available to protect against the two strains of HPV that cause most cases of cervical cancer. The vaccine is routinely offered to girls between the ages of 12 and 18. However, this vaccine does not protect against all strains of the virus that are associated with the cancer and it is therefore important for girls who have been vaccinated to have regular cervical smear tests later in life.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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