Definition
Cervical cancer is a malignant tumor of the lowermost part of the uterus (womb). Before cervical cancer appears, the cells of the cervix go through precancerous changes, known as dysplasia. This is usually a slow process that develops over many years.
Black women are the second most likely demographic to develop cervical cancer. Each year roughly 2,000 Black women are diagnosed with cervical cancer with more than 40% dying from the disease. Additionally, Black women are 80% more likely to die from this form of cancer than white women. Black women also have a lower 5-year survival rate than white women with Around 56% of Black women surviving after 5 years compared to 68% of white women. Black women are also less likely to receive adequate care.
Types of Cervical Cancer
Cervical cancer is classified based on the type of cell where it develops. The most common types of cervical cancer are:
- Squamous cell carcinoma (cancer): This is the most common type of cervical cancer and is found in 80% to 90% of cases. It develops in the lining of the cervix.
- Adenocarcinoma: This type of cervical cancer develops in gland cells that produce cervical mucus. About 10% to 20% of cervical cancers are adenocarcinomas.
- Mixed carcinoma (cancer): Occasionally, cervical cancer has features of squamous cell carcinoma and adenocarcinoma.
- In rare instances, other types of cancer, such as neuroendocrine (small and large cell cervical cancer), melanoma, sarcoma and lymphoma, are found in the cervix.
Causes
Most cases of cervical cancer are caused by infection with human papillomavirus (HPV), which usually is passed from person to person by sexual contact. According to MD Anderson, The average person’s lifetime risk of contracting HPV is about 80%. More than 100 different types of HPV can occur, at least 13 of which may cause cervical cancer. A Pap test given every three-to-five years looks for these changes. If precancerous cells are found, they often can be removed. Other risk factors that increase your chances of developing cervical cancer include:
Age: The risk of cervical cancer increases with age. It is found most often in women over the age of 40. However, younger women often have precancerous lesions that require treatment to prevent cancer.
Smoking: Cigarette smoke contains chemicals that damage the body’s cells. It increases the risk of precancerous changes in the cervix, especially in women with HPV.
Sexual behavior: Certain types of sexual activity may increase the risk of getting HPV infection. These include: 1) Multiple sexual partners, 2) high-risk male partners, 3) first intercourse at an early age and 4) not using condoms during sex.
Other cervical cancer risk factors include:
- Lack of regular Pap tests
- Having a sexually transmitted disease (STD), including chlamydia
- Diethylstilbestrol (DES) exposure before birth: This drug was used between 1940 and 1971 to help women not have miscarriages. Women whose mothers took DES during pregnancy have a high risk of vaginal and cervical cancers.
- HIV infection
- Weakened immune system: Having an organ transplant or taking steroids raises the risk of developing cervical cancer.
- Being overweight or not eating a healthy diet
Not everyone with risk factors gets cervical cancer. However,if you do have risk factor; you should consult with your doctor.
Treatments
Cervical cancer treatment options include surgery, radiotherapy, chemotherapy, or combinations of these. Your doctor will help you determine what kind of treatment is best for you based on the stage of the cancer, as well as your age and overall state of health.Treatment for early-stage cervical cancer, when the cancer remains within the cervix, has a good success rate. However, the further a cancer spreads from its original area, the lower the success rate tends to be.
Procedures available may include:
- Radiation
- Chemotherapy
- Radical hysterectomy
- Lymphatic mapping and sentinel lymph node biopsy
- Laparoscopic retroperitoneal lymph node dissection, a minimally invasive procedure to determine the extent of cancer and help plan treatment
- Fertility-sparing techniques, including radical trachelectomy, a highly specialized surgery that may help some women keep the ability to have children
Diagnosis
Early diagnosis will improve the success rate of your treatment.The American Cancer Society (ACS) recommends the following as routine screening:
- Under 25 years: The ACS does not recommend screening.
- From 25–65 years: People should undergo an HPV test every five years for cervical cancer.
- Over 65 years: The ACS do not recommend screening for those who have had adequate screening in the past, unless they have a high risk of cervical cancer.
If you had a hysterectomy with removal of the cervix, you do not need screening, unless you had precancerous lesions or cervical cancer in the past.
It should be noted that these are the overall screening recommendations, but a doctor can advise you about your specific screening needs.
If there are signs and symptoms of cervical cancer, or if the Pap test reveals abnormal cells, a doctor may recommend additional tests.
These include:
- Colposcopy: This is visual examination of the vagina using a speculum and a colposcope, a lighted magnifying instrument.
- Examination under anesthesia (EUA): The doctor can examine the vagina and cervix more thoroughly.
- Biopsy: The doctor takes a small section of tissue under general anesthesia.
- Cone biopsy: The doctor takes a small, cone-shaped section of abnormal tissue from the cervix for examination.
- LLETZ: Diathermy using a wire loop with an electric current helps remove abnormal tissue. The healthcare professional then sends the tissue to the lab for checking.
- Blood tests: A blood cell count can help identify liver or kidney problems.
- CT scan: A medical professional might use a barium liquid to show up any cellular abnormalities.
- MRI: Special types of MRI may be able to identify cervical cancer in its early stages.
- Pelvic ultrasound: High-frequency sound waves create an image of the target area on a monitor.
Prevention
The following methods can lower your risk of developing cervical cancer:
Human papillomavirus (HPV) vaccine
The link between the development of cervical cancer and some types of HPV is clear. If every female keeps to the current HPV vaccination programs, they could reduce the frequency of cervical cancer.
Safe sex and cervical cancer
The HPV vaccine only protects against two HPV strains. Other strains can cause cervical cancer. Using a condom during sex helps protect from HPV infection.
Cervical screening
Regular cervical screening might help a person identify and deal with signs of cancer before the condition can develop or spread too far. Screening does not detect cancer but indicates changes to the cells of the cervix.
Having fewer sexual partners
The more sexual partners a woman has, the higher the risk of transmitting the HPV virus becomes. This can lead to a higher risk of developing cervical cancer.
Delaying first sexual intercourse
The younger a woman is when she has sexual intercourse for the first time, the higher the risk of HPV infection becomes. The longer she delays it, the lower her risk.
Stopping smoking
Women who smoke and have HPV face a higher risk of developing cervical cancer than people who do not.