Cervical cancer arises from the cervix—the lower part of the uterus connecting to the vagina. It's predominantly caused by persistent infection with high-risk types of human papillomavirus (HPV), a common sexually transmitted infection. Early stages often present no symptoms, making regular screenings vital for early detection and effective treatment.

Overview

Cervical cancer develops when abnormal cells in the cervix grow uncontrollably. The two primary types are:

• Squamous Cell Carcinoma: Originates in the thin, flat cells lining the outer part of the cervix. This is the most common form, accounting for about 80% to 90% of cases.

• Adenocarcinoma: Develops in the glandular cells of the cervical canal and comprises about 10% to 20% of cervical cancers.

Causes

The primary cause of cervical cancer is persistent infection with high-risk HPV types, especially HPV 16 and 18. While most HPV infections resolve spontaneously, some can lead to cellular changes that progress to cancer over time. Additional risk factors include:

• Smoking: Doubles the risk by compromising the immune system's ability to fight HPV infections.

• Weakened Immune System: Conditions like HIV/AIDS or immunosuppressive medications can increase susceptibility.

• Long-term Use of Oral Contraceptives: Usage beyond five years may slightly elevate risk.

• Multiple Full-Term Pregnancies: Having three or more full-term pregnancies is associated with a higher risk.

• Early Pregnancy: Giving birth before age 17 increases risk compared to first births after age 25.

Symptoms

Early cervical cancer typically lacks noticeable symptoms. As the disease progresses, symptoms may include:

• Abnormal Vaginal Bleeding: Such as bleeding between periods, after intercourse, or post-menopause.

• Unusual Vaginal Discharge: May be watery, pink, or foul-smelling.

• Pelvic Pain: Especially during intercourse.

• Pain During Urination: Indicative of advanced stages.

These symptoms can result from other conditions; however, prompt medical evaluation is crucial for accurate diagnosis.

Diagnosis

Early detection significantly improves treatment outcomes. Diagnostic procedures include:

• Cervical Screening (Pap Smear): Detects precancerous changes by collecting cervical cells for examination.

• HPV DNA Test: Identifies high-risk HPV strains in cervical cells.

• Colposcopy: Uses a magnifying instrument to closely examine the cervix for abnormalities.

• Biopsy: Involves removing a small tissue sample for laboratory analysis to confirm cancer presence.

Treatment Methods

Treatment depends on the cancer's stage, size, and the patient's overall health and reproductive preferences. Options include:

• Surgery:

  • Conization: Removes a cone-shaped section of abnormal tissue; suitable for early-stage cancer.

  • Hysterectomy: Removes the uterus and cervix; can be total or radical, depending on cancer spread.

  • Trachelectomy: Removes the cervix and upper vagina, preserving fertility.

• Radiation Therapy: Uses high-energy rays to destroy cancer cells; can be external or internal (brachytherapy).

• Chemotherapy: Employs drugs to kill cancer cells, often combined with radiation in advanced stages.

• Targeted Therapy: Uses drugs that target specific cancer cell mechanisms; for example, bevacizumab inhibits blood vessel growth in tumors.

• Immunotherapy: Helps the immune system recognize and attack cancer cells; pembrolizumab is an example used in certain cases.

Frequently Asked Questions (FAQs)

1. How can I reduce my risk of cervical cancer?

• HPV Vaccination: Protects against the most common cancer-causing HPV strains.

• Regular Screenings: Pap smears and HPV tests can detect precancerous changes early.

• Safe Sexual Practices: Using condoms and limiting the number of sexual partners can reduce HPV transmission risk.

• Avoid Smoking: Eliminating tobacco use supports immune health.

2. Is cervical cancer hereditary?

Cervical cancer is not typically considered hereditary. However, genetic factors may influence individual susceptibility to HPV infections and cancer development.

3. Can cervical cancer be cured?

When detected early, cervical cancer is highly treatable, with a good prognosis. Advanced stages are more challenging but can often be managed with appropriate treatment.

4. At what age should I start cervical cancer screening?

Screening recommendations vary by country. Generally, women should begin screening at age 21 and continue regularly as advised by healthcare providers.

5. Does the HPV vaccine eliminate the need for screenings?

No, vaccinated individuals should still undergo regular screenings, as the vaccine doesn't protect against all HPV types that may cause cervical cancer.

Sources

• Cleveland Clinic: Cervical Cancer

• NHS: Cervical Cancer

• World Health Organization: Cervical Cancer

• Cancer Research UK: Cervical Cancer

Disclaimer: This information is for educational purposes and not a substitute for professional medical advice. Always consult a healthcare provider for diagnosis and treatment options.