Cervical Cancer

Cancer of cervix is second only to breast cancer as the most common type of cancer found in women worldwide. It affects an estimated 500,000 women each year.

Cervical cancer is a disease in which cancer cells develop in the tissues of cervix. The cervix,the lower part of the uterus which protrudes into the vagina, connects the body of the uterus to the vagina.

Nearly all cases of cervical cancer can be linked to the human papillomavirus, or HPV. There are more than 100 strains of HPV, and at least 15 high-risk types have been linked to cancer of the cervix. While most women who develop cervical cancer have HPV, only a small proportion of women infected with HPV develop cervical cancer. Only persistent HPV infection leads to cervical cancer. Additionally, some low -risk types of HPV cause vaginal and vulvar warts; other HPV strains cause the warts that sometimes develop on the hands or feet. Most women will be infected by HPV at some point in their lives. The virus is transmitted through skin to skin contact in the genital area, most often by sexual intercourse. Having HPV means you are at greater risk for developing cervical cancer.Most women with HPV will clear the virus on their own within 2 years. The HPV vaccine cannot treat HPV but can protect against the strains HPV 16 and 18 -that cause 70% of cervical cancers.

Health care professionals use Pap test to find abnormal cell change in cervical tissue that are cancerous or may become cancerous. The earlier cervical cancer is diagnosed, the better the chance for a cure. Because persistent infection with high-risk strains of HPV can be a predector of the presence of future development of pre-invasive and cervical cancer, many medical professionals now also test for the virus an adjunct to the Pap test.

The reason screening is so important in preventing cervical cancer is the disease usually causes no symptoms in its earliest stages. Irregular bleeding,bleeding or pain during intercourse or vaginal discharge may be symptoms of more advanced disease. All women are at risk for developing cancer, but several factors can increase a woman's of developing cervical cancer.

  • persistent infection with high- risk strains of HPV
  • A compromised immune system related to certain illnesses such HIV infection
  • Smoking cigarettes
  • Infection with chlamydia bacteria
  • A diet low in fruits and vegetables
  • A family history of cervical cancer

Detenting precancerous changes in their earliest stages through regular Pap tests is the best way to prevent cervical cancer. Most women who develop invasive cervical cancer have not had regular Pap tests. Reducing or eliminating risk factors associated with the development of cervical cancer can also help prevent it. Additionally two HPV vaccines protects women against four HPV types-the two most common high-risk(cancer-causing) types of HPV, strains 16 and 18, and also two most common low risk types of HPV 6 and 11, which cause 90 percent of genital warts. Both vaccines should be given before an infection occurs, ideally, before girl becomes sexually active.

For early detection and prevention of cervical cancer:

  • All women should begin screening at age 21
  • Women ages 21 to 29 should have Pap test every three years. They should not have an HPV test unless it is needed because of an abnormal Pap test result
  • Women ages 30 to 65 should have both a Pap test and an HPV test every five years or a Pap test alone every three years
  • Women over age 65 who have been screened previously with normal results and are not at high risk for cervical cancer should stop getting screened. Women with cervical precancer should continue to be screened
  • Women who have received the HPV vaccine should still follow the screening guidelines for their group

To help improve the reliability of your Pap test, schedule your appointment two weeks after your last menstrual period and refrain from doing the following for at least 48 hours before the test.

  • Having sex
  • Douching
  • Using tampons
  • Using vaginal cream,suppositories,medicine,sprays or powders

An abnormal Pap test result does not mean you have cervical cancer. It indicates some degree of change or abnormality in the cells that cover the surface (lining or epithelium) of the cervix.

While the Pap test cannot confirm an HPV infection, it can show cell changes that suggest infection with HPV.

Usually, cervical cancer grows slowly. Precancerous changes may not become cancerous for months or years. Once they spread deeper into cervical tissue or to other tissues and organs, the cellular abnormalities are classified as cervical cancer, or invasive cervical cancer. Cervical cancer tends to occur in midlife;about half of women diagnosed with cervical cancer are between the ages of 35 and 55, and it rarely occurs in women younger than 20.

A Pap test is a screening tool;other procedures are necessary to confirm Pap test abnormalities and diagnose conditions. All abnormal Pap test should have some form of action plan. This may include a "watch and wait" approach with retesting in several months ordepending on the degree of abnormality, your doctor may order other test,including:

  • Colposcopy: the doctor uses a colposcope to magnify and focus light on the vagina and cervix to view these areas in greater detail. Depending on these findings, your health care professional may than use one or following test:
  • Biopsy:during this procedure, sample tissue is taken from the cervical surface. Often several area are biopsied.
  • Endocervical curettage: this procedure evaluates a portion of the cervix that cannot be seen.
  • Cone biopsy:An extensive form of cervical biopsy
  • Loop Electrocautery Excision Procedure (LEEP): the suspicious area is removed with a loop device and remaining tissue is electrocoagulated. LEEP is both a diagnostic test and a treatment. A pathologist examines tissue removed during LEEP to be sure all the abnormal cells are removed.

If cancer of cervix is diagnosed, more tests will be conducted to learn if cancer cells have spread to other parts of the body.

The majority of cervical cancers develop through a series of gradual, well-defined precancerous lesions. During this usually lengthy process, the abnormal cells can be detected by the Pap test and treated.