Cervical cancer is a cancer of the cells of the neck of womb in women. The cervix is at the top of the vagina and is through which a baby is born.
Recent well publicised cases have increased the awareness regarding the importance of cervical cancer screening in the UK.
There are two main types of cervical cancer: sqaumous cell (more common), and adenocarcinoma cervical cancer. Both present and are diagnosed and treated in the same way.
Statistics of Cervical Cancer
- In the UK, cervical cancer is the second most common cancer found in women.
- Approximately 1000 women a year in the UK still die of cervical cancer, but these numbers have greatly reduced over the last few years due to the introduction of screening.
- Cervical cancer is a sexually transmissible cancer as the large majority of cases are caused by infection with the human papilloma virus (HPV).
- Most women are diagnosed in their 30s or 40s.
- Cervical cancer is rare before the age of 25 years, and hence this is the age at which screening begings in the UK.
- It develops during a period of 5 to 15 years which begins with an infection from the Human Papilloma Virus (HPV) which represents the major risk factor of the uterus cancer.
Risk Factors and Causes
The main risk factor for you to develop cervical cancer is the Human Papilloma Virus (HPV), which is outlined below. Other risks include:
- A poor immune system
- Some oral contraceptive pills, especially if taken long term
- Multiple children
Human Papilloma Virus (HPV)
HPV is the major risk factor for cervical cancer and is transmitted by simple contact with the skin during unprotected sexual intercourse.
There are many types of HPV, such as the ones that cause genital warts, which are unrelated to cervical cancer.
The HPV strains associated with cervical cancer cause no daily symptoms, but they initiate the cells of the cervix to become abnormal and after many years may cause cancer. Not everyone who gets HPV develops cancer as most HPVs (90%) are cleared from the body within 2 years, but you need to make sure you reduce other risk factors and have regular smears.
Screening for Cervical Cancer: Cervical Smear
Cervical cancer prevention is based on the smear test.
This involves your doctor or nurse inserting a speculum inside your vagina, and taking some cells from the surface of the cervix with a small brush. These cells are then transferred into liquid and examined under the microscope. This enables to detect abnormal cells which could potentially become dangerous and prevent cervical cancer before it actually happens.
Screening for cervical cancer in the UK is done from the age of 25 to 60, every 3-5 years. You may be recalled earlier if your smear is inadequate (not enough cells were taken) or abnormal ("dyskaryotic").
Your doctor or nurse will be able to explain the results to you approximately 3 weeks later, and they may refer you to the colposcopy clinic run by gynaecologists in your local hospital if you need any further treatment.
Symptoms of Cervical Cancer
Vaginal bleeding is the most common presenting symptom - this can be after sex, in between your periods, or after the menopause.
You may have a concurrent sexually transmitted infection, vaginal discharge, and/or pelvic pain.
These symptoms are not specific to cervical cancer, but you must visit your GP if you have any of these symptoms.
Assessment and Treatment
Your GP will examine you internally, and perform a smear. He/she may also request an ultrasound scan or refer you to a gynaecologist immediately.
Treatment depends on your cancer - options include surgery, radiotherapy or chemotherapy.
Surgery usually means "colposcopy" where the specialist will remove only the lower part of the cervix. This intervention leaves in place a part of the cervix. If the cancer has spread, the surgeon is sometimes obliged to perform an hysterectomy.
Vaccine against Cervical Cancer
There is a national screening programme for vaccination against the HPV vaccine for girls from the age of 12 in the UK.
It is given at this age before the patient is sexually activce, so the vaccine will work better according to studies.
Even if you have the vaccination, you still need regular cervical smears as we do not know how long the vaccine will protect you.