Cervical cancer occurs when abnormal cells grow uncontrollably in a woman's cervix, the lower part of the uterus, where it joins the vagina. The cervix produces lubricant for the vagina and mucus to help the motility of sperm. Human papillomavirus (HPV) is a virus transmitted by sexual activity, and is the cause of the vast majority of cases of cervical cancer. The abnormal cells in the cervix can grow to form a tumor, and in cases of advanced cervical cancer, cells can spread to other parts of the body (metastasize). Before cervical cells become cancerous, they undergo abnormal changes (dysplasia). Pap tests aim to detect these abnormal changes prior to the development of cancer.
The lower part of the uterus, leading out into the vagina.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
The American Cancer Society recommends that women follow these guidelines to help find cervical cancer early. Following these guidelines can also find pre-cancers, which can be treated to keep cervical cancer from forming.
Some women believe that they can stop cervical cancer screening once they have stopped having children. This is not true. They should continue to follow American Cancer Society guidelines The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer.
Although annual (every year) screening should not be done, women who have abnormal screening results may need to have a follow-up Pap test (sometimes with a HPV test) done in 6 months or a year.
The American Cancer Society guidelines for early detection of cervical cancer do not apply to women who have been diagnosed with cervical cancer, cervical pre-cancer, or HIV infection. These women should have follow-up testing and cervical cancer screening as recommended by their health care team.
The lower part of the uterus, leading out into the vagina.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
The cause of cervical cancer, as with other cancers, is damage to cellular DNA. This damage results in uncontrolled cell growth, which leads to formation of a tumor. The tumors can invade nearby tissue, or cancerous cells can spread throughout the body via the bloodstream or lymphatic system. Human papillomavirus (HPV) is believed to cause most cases of cervical cancer. Importantly, the virus strains (types) involved in causing cervical cancer are different to those that cause genital warts.
The genetic material of all living cells and some viruses. The full name is deoxyribonucleic acid.
A network of vessels, lymph nodes, the spleen and other organs that transport lymph fluid between tissues and bloodstream.
Risk factors for cervical cancer include:
The main risk factor for cervical cancer is HPV, which is responsible for almost all cases. Although HPV is the main cause of cervical cancer, most women with HPV won't develop the cancer. HPV is an extremely common virus in people who have been sexually active and it has no symptoms. Some strains of HPV are responsible for genital warts, but these are not the same strains that are involved in development of cervical cancer. Although the viral infection cannot be removed with medication, your immune system can often clear it naturally. When your immune system cannot clear the virus, the ongoing infection may lead to cervical cancer. A vaccination against the HPV strains is available. It is suitable for both sexes and, to be most effective in preventing transmission of the virus, should be administered to young adults before they start to have sex.
As with many other types of cancer, smoking increases the risk of developing cervical cancer.
Daughters of women who took this anti-miscarriage drug (which is no longer in use) are at an increased risk of developing cervical cancer.
Squamous cell carcinoma is a type of cancer that originates in the squamous cells that cover the cervix where it is protruding into the vagina. It is the most common type of cervical cancer and is usually easily detected by a Pap test. If a Pap test is positive for changes, a colposcopy and biopsy need to be performed to confirm the diagnosis (see below).
This cancer is less common and originates in the glandular cells of the cervical canal. The Pap test is not as effective at picking up abnormalities that lead to this type of cancer.
The lower part of the uterus, leading out into the vagina.
Examination of the cervix using a special microscope called a colposcope, to closely identify any abnormalities.
Treatment outcomes can vary greatly depending on the stage of cancer. Cancer is staged according to the size and location of the primary tumor and whether it has spread to nearby or distant lymph nodes, or organs throughout the body.
| Stage 1 | The cancer is only in the cervix. |
| Stage 2 | The cancer has spread outside the cervix, but not to the pelvic wall or lower third of the vagina. |
| Stage 3A | The cancer has spread to the pelvic wall only. |
| Stage 3B | The cancer has spread to the pelvic wall and grown large enough to block the ureter and disrupt the flow of urine from the kidneys to the bladder. |
| Stage 4 | The cancer has spread to other parts of the body such as the bladder, or to more distant organs such as the vital organs. |
Different stages of cervical cancer.
The lower part of the uterus, leading out into the vagina.
There are usually no symptoms of the early, dysplastic changes of the cervix, and it is at this stage that a Pap test can identify presence of any abnormal cells in the cervix. When symptoms do occur, they can include:
These are also symptoms of other non-cancerous causes of these symptoms, so it is important to talk to your doctor if you are concerned.
The lower part of the uterus, leading out into the vagina.
During a Pap test, some cells are scraped or brushed from the cervix and smeared onto a glass slide, which is sent to a laboratory where a cell specialist (a cytologist) checks for presence of abnormalities. As this is a screening test, it can have either a false positive or a false negative result. If there are suspicious findings from the Pap test, a colposcopy and biopsy will then be carried out to confirm the diagnosis.
During a colposcopy, a magnifying instrument is used to check the cervix and vagina for abnormalities. This allows the doctor a more detailed view of the cervix. Sometimes dyes or acids are used to show up certain abnormalities.
One or more small tissue samples (biopsy) may be taken from the cervix during a colposcopy. These are then assessed for presence of any abnormalities.
A larger tissue sample is removed from the cervix, usually under a general anesthetic.
The lower part of the uterus, leading out into the vagina.
An anesthetic given to a person to put them to sleep while having an operation or medical procedure. Afterwards, the person regains consciousness and usually has no memory of the procedure. A general anesthetic is given in hospital by a specialist called an anesthetist.
Examination of the cervix using a special microscope called a colposcope, to closely identify any abnormalities.
An incorrect result from a medical test that falsely indicates presence of a disease or condition.
An incorrect result from a medical test that falsely indicates absence of a disease or condition.
A radical hysterectomy involves the surgical removal of the uterus, the upper part of the vagina and the lymph nodes surrounding the uterus.
Cervical cancer can be removed with a cone biopsy if it is detected early enough and if the doctor is confident the entire tumor can be removed by this technique.
Chemotherapy works by attacking cancer cells and stopping their reproduction. Various medications are used, which can be administered intravenously or orally.
There are three general types of chemotherapy:
Side effects occur because chemotherapy can also affect the reproduction of healthy cells. Your doctor will monitor your dosage carefully to ensure an optimal therapeutic dosage is achieved.
Chemotherapy medication is effective in destroying cancerous cells.
In this type of therapy, focused X-rays are applied to the area where the tumor is located. Another form of radiation therapy is brachytherapy. This involves inserting a small, radioactive implant in the tumor or the nearby area, which delivers cell-destroying radiation directly into the tumor. Radiotherapy can be used alone, or in addition to surgery and/or chemotherapy.
Some people diagnosed with cancer seek out complementary and alternative therapies. None of these alternative therapies are proven to cure cancer, but some can help people feel better when used together with conventional medical treatment. It is important to discuss any treatments with your doctor before starting them since some complementary treatments can cause harm or interfere when combined with conventional cancer treatment.
The hollow organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. Also known as the womb.
The surgical removal of the ovaries, or damage to them during radiotherapy, can result in early menopause.
Radiotherapy can narrow the vagina, making sex uncomfortable or painful. There are treatments available that may help to alleviate these symptoms.
The lymphatic system drains excess body fluid. Surgical removal of the lymph nodes can result in a build-up of fluid which can cause swelling. Massage and compression clothing can help relieve this swelling.
Other treatment side effects include:
Metastasis is the spread of cancer to other parts of the body through the bloodstream and lymphatic system. The growth of cancer in the organs and other body parts results in a destructive effect on their function.
The kidneys are the waste removal centers of the body. In some cases of cervical cancer, the tumor can exert pressure on the tubes through which the urine flows from the kidneys to the bladder (ureters). The resulting build-up of urine in the kidneys (hydronephrosis) can lead to kidney failure. Surgery can be carried out to widen the ureters or to insert drainage channels for the urine.
As with other cancers, cervical cancer can result in blood being more likely to form clots in the veins. Anticoagulant medications are used to reduce the risk of clots forming. Clots in the veins of the leg or pelvis can separate from the wall of the vein and then can block the of the arteries in the lungs. This is called a pulmonary embolism, a potentially life threatening condition.
Bleeding may occur when the cancer spreads and damages the vagina, bladder or bowel. Radiotherapy and certain medications can be used to alleviate the bleeding.
Fistulas are abnormal passages that, in cervical cancer, usually form between the bladder and vagina or between the vagina and bowel. They can lead to the discharge of urine or feces from the vagina. Surgery is required to correct the fistula, but isn't always possible, in which case certain medications may be used.
A network of vessels, lymph nodes, the spleen and other organs that transport lymph fluid between tissues and bloodstream.
If diagnosed early, cervical cancer is curable.
This year, an estimated 12,820 women in the United States will be diagnosed with cervical cancer. It is estimated that 4,210 deaths from the disease will occur this year.
The 5-year survival rate tells you what percent of women live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate for all women with cervical cancer is 68%. For white women, the 5-year survival rates are 69%, and for black women, the 5-year survival rate is 57%.
Survival rates depend on many factors, including the stage of cervical cancer that is diagnosed.
When detected at an early stage, the 5-year survival rate for women with invasive cervical cancer is 91%. About 46% of women with cervical cancer are diagnosed at an early stage. If cervical cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year survival rate is 57%. If the cancer has spread to a distant part of the body, the 5-year survival rate is 17%.
It is important to remember that statistics on the survival rates for women with cervical cancer are an estimate. The estimate comes from annual data based on the number of women with this cancer in the United States. Women should talk with their doctor if they have questions about this information. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Advances in treatment since then might result in better outcomes for people with cervical cancer today.
The most important thing to do is to have regular Pap tests and follow the recommendations of your doctor in case of an abnormal result. The human papillomavirus (HPV) vaccine, given prior to having sex for the first time, is very effective at reducing rates of the common types of HPV. However, since it is not effective against all strains of the HPV, regular Pap tests are still recommended. Using condoms and limiting the number of sexual partners you have will also reduce the risk of exposure to the different strains of HPV.
The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer