Carcinoma Cervix

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world health organisation

Cervical cancer develops in a woman’s cervix (the entrance to the uterus from the vagina).  

Almost all cervical cancer cases (99%) are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact.

Although most infections with HPV resolve spontaneously and cause no symptoms, persistent infection can cause cervical cancer in women.

Cervical cancer is the fourth most common cancer in women. In 2018, an estimated 570 000 women were diagnosed with cervical cancer worldwide and about 311 000 women died from the disease.

Effective primary (HPV vaccination) and secondary prevention approaches (screening for, and treating precancerous lesions) will prevent most cervical cancer cases.

When diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively. Cancers diagnosed in late stages can also be controlled with appropriate treatment and palliative care.

With a comprehensive approach to prevent, screen and treat, cervical cancer can be eliminated as a public health problem within a generation.

Overview

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.

When exposed to HPV, the body’s immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells.

You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

Symptoms

Early-stage cervical cancer generally produces no signs or symptoms.

Signs and symptoms of more-advanced cervical cancer include:

  • Vaginal bleeding after intercourse, between periods or after menopause
  • Watery, bloody vaginal discharge that may be heavy and have a foul odor
  • Pelvic pain or pain during intercourse

Causes

Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell’s DNA contains the instructions that tell a cell what to do.

Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.

It isn’t clear what causes cervical cancer, but it’s certain that HPV plays a role. HPV is very common, and most people with the virus never develop cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you’ll develop cervical cancer.

Types of cervical cancer

The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are:

  • Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas.
  • Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal.

Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.

Risk factors

Risk factors for cervical cancer include:

  • Many sexual partners. The greater your number of sexual partners — and the greater your partner’s number of sexual partners — the greater your chance of acquiring HPV.
  • Early sexual activity. Having sex at an early age increases your risk of HPV.
  • Other sexually transmitted infections (STIs). Having other STIs — such as chlamydia, gonorrhea, syphilis and HIV/AIDS — increases your risk of HPV.
  • A weakened immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
  • Smoking. Smoking is associated with squamous cell cervical cancer.
  • Exposure to miscarriage prevention drug. If your mother took a drug called diethylstilbestrol (DES) while pregnant in the 1950s, you may have an increased risk of a certain type of cervical cancer called clear cell adenocarcinoma.

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Prevention

To reduce your risk of cervical cancer:

Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.

Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections, such as using a condom every time you have sex and limiting the number of sexual partners you have.

cervicak cancer test

A Pap smear is a test doctors use to diagnose cervical cancer. To perform this test, your doctor collects a sample of cells from the surface of your cervix. These cells are then sent to a lab to be tested for precancerous or cancerous changes.

If these changes are found, your doctor may suggest a colposcopy, a procedure for examining your cervix. During this test, your doctor might take a biopsy, which is a sample of cervical cells.

The U.S. Preventive Services Task Force (USPSTF)recommends the following screening schedule for women by age:

Ages 30 to 65: Get a Pap smear once every three years, get a high-risk HPV (hrHPV) test every five years, or get a Pap smear plus hrHPV test every five years.

prognosis

For cervical cancer that’s caught in the early stages, when it’s still confined to the cervix, the five-year survival rate is 92 percent

statistic

Here are some key statistics about cervical cancer.

The American Cancer Society estimates that in 2019, approximately 13,170 American women will be diagnosed with cervical cancer and 4,250 will die from the disease. Most cases will be diagnosed in women between the ages of 35 and 44.

Hispanic women are the most likely ethnic group to get cervical cancer in the United States. American Indians and Alaskan natives have the lowest rates.

The death rate from cervical cancer has dropped over the years. From 2002-2016, the number of deaths was 2.3 per 100,000 womenper year. In part, this decline was due to improved screening.

cervical cancer and pregnancy

It’s rare to get diagnosed with cervical cancer while you’re pregnant, but it can happen. Most cancers found during pregnancy are discovered at an early stage.

Treating cancer while you’re pregnant can be complicated. Your doctor can help you decide on a treatment based on the stage of your cancer and how far along you’re in your pregnancy.

If the cancer is at a very early stage, you may be able to wait to deliver before starting treatment. For a case of more advanced cancer where treatment requires a hysterectomy or radiation, you’ll need to decide whether to continue the pregnancy.

Doctors will try to deliver your baby as soon as it can survive outside the womb.

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