Cervical Cancer: Risks, Causes, Symptoms, and Treatment

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 the channel through which a baby is born.

There are two main types of cervical cancer: sqaumous cell and adenocarcinoma cervical cancer. Both present themselves and are diagnosed and treated in the same way.

Cervical Cancer Statistics

In the UK, cervical cancer, which develops over a period of 5 to 15 years, is the second most common cancer found in women. Approximately 1,000 women a year in the 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 untreated infection with the human papillomavirus (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 begins in the UK.

Risk Factors and Causes of Cervical Cancer

The main risk factor for an individual to develop cervical cancer is the Human papillomavirus (HPV). Other risks include: smoking; a poor immune system; some oral contraceptive pills, especially if taken long term; having had multiple children.

Human Papillomavirus (HPV) and Cervical Cancer

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 90% HPV infections are cleared from the body within 2 years. However, it is wise to make sure to reduce other risk factors and to have regular smears.

Screening for Cervical Cancer (Pap Smear)

Cervical cancer prevention is based on the smear test, sometimes known as a cervical smear or a pap smear.

This involves a doctor or nurse inserting a speculum inside of a patient's 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 a microscope. This enables a doctor or nurse to detect abnormal cells that could potentially become dangerous and to prevent any potential cervical cancer.

Screening for cervical cancer in the UK is done from the age of 25 to 60, once every 3-5 years. A patient may be recalled earlier if her smear is inadequate (e.g. not enough cells were taken) or abnormal (i.e. dyskaryotic).

A doctor or nurse will be able to explain the results to a patient approximately 3 weeks later, and they may refer the patient to the colposcopy clinic run by gynecologists for any further treatment.

Symptoms of Cervical Cancer

Vaginal bleeding is the most common presenting symptom: this can occur after sex, in between periods, or after menopause.

It is possible to have a concurrent sexually transmitted infection, vaginal discharge, and/or pelvic pain.

These symptoms are not specific to cervical cancer, but it is advisable to visit a GP if any of these symptoms present themselves.

Assessment and Treatment

A GP will examine the patient internally and perform a smear. He/she may also request an ultrasound scan or refer the patient to a gynecologist immediately.

Treatment depends on the cancer involved: options include surgery, radiotherapy, or chemotherapy.

Surgery usually involves a 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 program for vaccination against HPV for girls starting at the age of 12 in the UK.

It is given at this age before the patient is sexually active, so that the vaccine will work better according to studies.

Even if a patient has the vaccination, she will still need regular cervical smears as it is unknown how long the vaccine will protect her.

Image: © Tefi - Shutterstock.com
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