Cervical Cancer

Cancer of the cervix is one of the most common cancers that affect a woman's reproductive organs. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, are responsible for the majority of cervical cancer cases.

When exposed to HPV, the immune system response in most women prevents the virus from doing harm. In a small group of women, however, the virus survives for years before it eventually converts some cells on the surface of the cervix into cancer cells. Older women are most at risk of developing cervical cancer.

Thanks largely to Pap test screening, the death rate from cervical cancer has decreased greatly over the last 40 years. Still, every year more than 12,000 women in the United States find out that they have invasive cervical cancer, and approximately 4,000 die of the disease. African-American women have the highest death rate from cervical cancer (6.7 per 100,000) which is more than twice that of other ethnic groups.

[top]

Early cervical cancer generally produces no signs or symptoms. As the cancer progresses, these signs and symptoms may appear:

• Bleeding from your vagina after intercourse, between periods or after menopause
• Watery, bloody discharge from your vagina that may be heavy and have a foul odor

[top]

These factors increase your risk of cervical cancer:

• Many sexual partners - The greater the number of sexual partners you have had — and the number of partners that your partners have had — the greater your chance of acquiring HPV.
• Early sexual activity - Having first sexual intercourse before age 18 increases your risk of HPV. Immature cells seem to be more susceptible to the precancerous changes that HPV can cause.
• Other sexually transmitted diseases (STDs) - If you have other STDs, such as chlamydia, gonorrhea, syphilis or HIV/AIDS, you have a greater chance of having been exposed to HPV.
• Cigarette smoking - The exact mechanism that links cigarette smoking to cervical cancer isn't known, but tobacco use increases the risk of precancerous changes as well as cancer of the cervix.

[top]

The best ways to prevent cervical cancer are to:

• Delay first intercourse
• Have fewer sexual partners
• Use condoms
• Have routine Pap tests

Routine Pap tests are the most successful and accurate method of early detection. Work with your doctor to figure out the best schedule for Pap tests. Current guidelines suggest:

• An initial Pap test when you first begin having sexual intercourse or at age 18 if you haven't been sexually active
• Less frequent testing after three consecutive annual Pap tests with normal results
• Subsequent Pap tests at least every three years and continued for life, because the risk of invasive cervical cancer increases with age

If you're at high risk of cervical cancer, you'll need to have more frequent Pap tests. If you've had a hysterectomy, talk with your doctor about whether to continue getting Pap tests. If the hysterectomy was done for a noncancerous condition, such as fibroids, you may discontinue routine Pap tests, but not pelvic exams. If the hysterectomy was done for a precancerous or cancerous condition, your vaginal canal still needs to be checked for abnormal changes.

According to a Nov. 21, 2002, report published in The New England Journal of Medicine, a new vaccine appears to prevent cervical cancer. The vaccine works by making people immune to the human papillomavirus type 16 (HPV-16), the leading cause of cervical cancer.

Researchers have cautioned that the vaccine wouldn't remove the need for routine Pap tests to screen for cervical cancer, because the vaccine can't prevent every virus that causes the disease. Although potentially effective, the vaccine is experimental and won't be available to the public for several years. More trials are needed to make sure the vaccine is safe and effective.

[top]

Pre-invasive stage
Treatment of cervical cancer in the pre-invasive stage, when it has affected only the outer layer of the lining of the cervix, may include:

• Simple surgery - This involves removing with a scalpel a cone-shaped piece of cervical tissue where the abnormality is found.
• Laser surgery - This operation uses a narrow beam of intense light to kill cancerous and precancerous cells.
• Loop electrosurgical excision procedure (LEEP) - This technique uses a wire loop to pass electrical current, which cuts like a surgeon's knife, and remove cells from the mouth of the cervix.
• Cryosurgery - This technique involves freezing and killing cancerous and precancerous cells
• Hysterectomy - This major surgery involves removal of the cancerous and precancerous areas, the cervix and the uterus.

Invasive stage
Treatment for invasive cervical cancer is surgery to remove the uterus and any other abnormal tissue, followed by radiation, chemotherapy, and biological therapy as needed.

[top]

According to the American Cancer Society (ACS), the five-year survival rate for pre-invasive cervical cancer is almost 100 percent. The five-year survival rate is defined as the percentage of women who live five years or longer after receiving a diagnosis of cervical cancer. Many women live much longer.

Many women are treated successfully for invasive cervical cancer and live full, productive lives. According to the ACS, the five-year survival rate is more than 90 percent when the cancer is still confined to the cervix.

[top]

* Text Resources: The Mayo Clinic Staff