Cervical Cancer
Condition
(Cancer of the Cervix)
Definition
Cervical cancer is cancer that forms in tissues of the cervix. The cervix is the lower, narrow part of the uterus. It connects the uterus with the vagina.
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Causes
Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.
Human papillomavirus (HPV) is a sexually transmitted infection. It can cause changes in cervical cells. These changes can lead to cancer.
It is not clear what causes changes in the cells. It is likely a combination of genes and the environment.
Risk Factors
Cervical cancer is more common in women 40 to 49 years of age. The risk is higher in countries with limited medical resources.
The most common risk is having HPV infection and cervical dysplasia. Other things that raise the risk are:
- Having many sexual partners or unprotected sex
- Sexual activity before age 18
- A history of being pregnant more than once or before 19 years of age
- Smoking
- Using birth control pills for more than 5 years
- A history of a sexually transmitted infection (STI)
- A weak immune system, such as with HIV
- A family history of cervical cancer
Symptoms
Symptoms usually do not appear until the cells are cancerous. Then, they invade nearby tissue. When this happens, the most common symptom is abnormal bleeding. This may include:
- Bleeding between menstrual periods
- Long lasting or heavy menstrual bleeding
- Bleeding after sex, douching, or a pelvic exam
- Vaginal bleeding after menopause
- Increased vaginal discharge
- Pelvic or back pain
Diagnosis
Many women are diagnosed after an abnormal pap test.
Others may go to the doctor due to symptoms. The doctor will ask about symptoms and health history. A pelvic exam and will be done.
Tests may include:
- Blood and urine tests to look for signs that point to cancer
- Colposcopy —a lighted scope is used to view the cervix
- Biopsy —a sample of cervical tissue or lymph nodes is removed for testing
Pictures of the cervix may be taken. This can be done with:
The exam and test results will be used for staging. This will outline how far and fast the cancer has spread.
Treatment
The goal is to get rid of the cancer. Treatment depends on the stage of the cancer. A combination of treatments may be used.
Options may be:
- External or internal radiation treatment—to kill cancer cells or shrink tumors
- Chemotherapy by pills, injection, or IV—to kill cancer cells
- Surgery to remove a tumor, nearby tissue, and sometimes nearby lymph nodes
- Hysterectomy—to remove all or part of the uterus
- Surgery to remove other tissue, such as ovaries and fallopian tubes
- Medicines to control pain and bleeding
Prevention
The risk of this problem may be lowered by:
- Regular pap tests—to screen for tissue changes in the cervix
- Safe sex—limiting the number of sex partners and using latex condoms
- The HPV vaccine
American Cancer Society
National Cancer Institute
CANADIAN RESOURCES:
Canadian Cancer Society
Health Canada
American Cancer Society
National Cancer Institute
CANADIAN RESOURCES:
Canadian Cancer Society
Health Canada
References
- Cervical cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/cervical-cancer.html.
- Cervical cancer. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/cancer/cervical.
- Cervical cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cervical-cancer .
- Cervical cancer—health professional version. National Cancer Institute website. Available at: https://www.cancer.gov/types/cervical/hp.
- Human papillomavirus (HPV) vaccines. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet.
- Immunization schedules. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/schedules/index.html.
- Practice Bulletin No. 183 summary: postpartum hemorrhage. Obstet Gynecol. 2017;130(4):923-925.
Contributors
- Elizabeth Margaret Prusak, MD
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