Cervical Cancer

What is cancer of the cervix?

Cancer of the cervix, a common kind of cancer in women, is a disease in which cancer (malignant) cells are found in the tissues of the cervix. The cervix is the opening of the uterus (womb). The uterus is the hollow, pear-shaped organ where a baby
develops. The cervix connects the uterus to the vagina (birth canal).

Cancer of the cervix usually grows slowly over a period of time. Before cancer cells are found on the cervix, the tissues of the cervix go through changes in which cells that are not normal begin to appear (known as dysplasia). A Pap smear will usually find these cells. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.

Since there are usually no symptoms associated with cancer of the cervix, a doctor should do a series of tests to look for it. The first of these is a Pap smear, which is done by using a piece of cotton, a brush, or a small wooden stick to gently scrape the outside of the cervix in order to pick up cells. Pressure is sometimes felt and it is usually not accompanied by pain.

If cells that are not normal are found, the doctor will need to cut a sample of tissue (this procedure is called a biopsy) from the cervix and look at it under a microscope to see if there are any cancer cells. A biopsy that needs only a small amount of tissue may be done in the doctor's office. A person may need to go to the hospital if the doctor needs to remove a larger, cone-shaped biopsy specimen (conization).

The prognosis (chance of recovery) and choice of treatment depend on the stage of the cancer (whether it is just in the cervix or has spread to other places) and the patient's general health.

Can cervical cancer be prevented?

Many cases of cervical cancer are associated with known risk factors for the disease. Many risk factors are modifiable though not all can be avoided.

Screening History

Women who have not regularly had a Pap test are at increased risk of
cervical cancer. In particular, many women over age 60 have not had
regular Pap tests and are at increased risk. Receiving regular gynecological exams and Pap tests are the most important steps in preventing cervical cancer. Abnormal changes in the cervix can be detected by the Pap test and treated before cancer develops.

HPV Infection

There are over 80 types of human papillomavirus (HPV). At least two dozen
types are transmitted sexually and can infect the cervix. About half of
these have been linked to cervical cancer. Cervical infection with HPV is
the primary risk factor for cervical cancer. However, HPV infection is
very common and only a very small percentage of women infected with
untreated HPV will develop cervical cancer.

Sexual History

Women who begin having sexual intercourse before they are 16 years old,
and women who have had many sexual partners are at a greater risk of HPV
infection and developing cervical cancer. A number of professional groups
recommend that all women receive regular gynecological exams at the onset
of sexual activity or by 18 years of age. The prevention of sexually
transmitted diseases reduces the risk of cervical cancer.

Smoking

Cigarette smoking may be associated with an increased risk of cervical
cancer. Many studies have shown an association while other studies have
not.

Diet

Several studies have suggested that various micronutrients, such as
carotene and vitamins C and E, may reduce the risk of cervical cancer.

Finally, educating women about the risk factors for cervical cancer may lead to lifestyle and behavioral changes that result in decreased exposure to these factors.
 

Reference:  PDQ 7/99