Cervical cancer causes, risk factors, treatment

Cervical Cancer

Cancer is a disease in which cells in the body grow out of control. Cancer is always named for the part of the body where it starts, even if it spreads to other body parts later.

When cancer starts in the cervix, it is called cervical cancer. The cervix is the lower, narrow end of the uterus. The cervix connects the vagina (birth canal) to the upper part of the uterus. The uterus (or womb) is where a baby grows when a woman is pregnant.

Cervical cancer is highly preventable in most Western countries because screening tests and a vaccine to prevent human papillomavirus (HPV) infections are available. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

What Are the Risk Factors for Cervical Cancer?

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   Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts

HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms so you can't tell that you have it. For most women, HPV will go away on its own; however, if it does not, there is a chance that over time it may cause cervical cancer.

Other things can increase your risk of cervical cancer—

• Smoking.
• Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems.
• Using birth control pills for a long time (five or more years).
• Having given birth to three or more children.
• Having several sexual partners.

How to reduce the risk factor 

Two tests can help prevent cervical cancer—

1. ThePap test(or Pap smear) looks for precancers, cell changes on the cervix that may become cervical cancer if they are not treated appropriately. You should start getting Pap tests at age 21.
2. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes.

The most important thing you can do to help prevent cervical cancer is to have regular screening tests starting at age 21.

If your Pap test results are normal, your chance of getting cervical cancer in the next few years is very low. For that reason, your doctor may tell you that you will not need another Pap test for as long as three years. If you are 30 years old or older, you may choose to have an HPV test along with the Pap test. If both test results are normal, your doctor may tell you that you can wait five years to have your next Pap test. But you should still go to the doctor regularly for a checkup.

For women aged 21–65, it is important to continue getting a Pap test as directed by your doctor—even if you think you are too old to have a child or are not having sex anymore. However, if you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed as part of a total hysterectomy for a non-cancerous condition, like fibroids, your doctor may tell you that you do not need to have a Pap test anymore.

Getting an HPV Vaccine

Two HPV vaccines are available to protect females against the types of HPV that cause most cervical, vaginal, and vulvar cancers. Both vaccines are recommended for 11- and 12-year-old girls, and for females 13 through 26 years of age who did not get any or all of the shots when they were younger. These vaccines also can be given to girls as young as 9 years of age. It is recommended that females get the same vaccine brand for all three doses, whenever possible. It is important to note that women who are vaccinated against HPV still need to have regular Pap tests to screen for cervical cancer.

More Steps to Help Prevent Cervical Cancer

These things may also help lower your risk for cervical cancer—

• Don’t smoke.
• Use condoms during sex.*
• Limit your number of sexual partners.

*HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer.

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What Should I Know About Screening?

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Cervical cancer is the easiest gynecologic cancer to prevent, with regular screening tests and follow-up. Two screening tests can help prevent cervical cancer or find it early—

• The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
• The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.

The Pap test is recommended for all women between the ages of 21 and 65 years old, and can be done in a doctor’s office or clinic. During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory will check to be sure that the cells are normal.

How to Prepare for Your Pap Test

You should not schedule your Pap test for a time when you are having your period. If you are going to have a Pap test in the next two days—

• You should not douche (rinse the vagina with water or another fluid).
• You should not use a tampon.
• You should not have sex.
• You should not use a birth control foam, cream, or jelly.
• You should not use a medicine or cream in your vagina.

If you get the HPV test along with the Pap test, the cells collected during the Pap test will be tested for HPV at the laboratory. Talk with your doctor, nurse, or other health care professional about whether the HPV test is right for you.

When you have a Pap test, the doctor may also perform a pelvic exam, checking your uterus, ovaries, and other organs to make sure there are no problems. There are times when your doctor may perform a pelvic exam without giving you a Pap test. Ask your doctor which tests you are having, if you are unsure.

If you have a low income or do not have health insurance, you may be able to get a free or low-cost Pap test through the National Breast and Cervical Cancer Early Detection Program. 

When to Get Screened

You should start getting regular Pap tests at age 21. The Pap test, which screens for cervical cancer, is one of the most reliable and effective cancer screening tests available.

The only cancer for which the Pap test screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. So even if you have a Pap test regularly, if you notice any signs or symptoms that are unusual for you, see a doctor to find out why you’re having them. If your Pap test results are normal, your doctor may tell you that you can wait three years until your next Pap test.

Prevent Cervical Cancer with the Right Test at the Right Time infographic

If you are 30 years old or older, you may choose to have an HPV test along with the Pap test. Both tests can be performed by your doctor at the same time. When both tests are performed together, it is called co-testing. If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may then tell you that you can wait as long as five years for your next screening. But you should still go to the doctor regularly for a checkup.

If you are 21 to 65 years old, it is important for you to continue getting a Pap test as directed by your doctor—even if you think you are too old to have a child or are not having sex anymore. If you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids, your doctor may tell you that you do not need to have a Pap test anymore.

Test Results

It can take as long as three weeks to receive your test results. If your test shows that something might not be normal, your doctor will contact you and figure out how best to follow up. There are many reasons why test results might not be normal. It usually does not mean you have cancer.

If your test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. It is important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

 

How Is Cervical Cancer Diagnosed and Treated?

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If your doctor says that you have cervical cancer, ask to be referred to a gynecologic oncologist—a doctor who has been trained to treat cancers of a woman’s reproductive system. This doctor will work with you to create a treatment plan.

The extent of disease is referred to as the stage. Information about the size of the cancer or how far it has spread is often used to determine the stage. Doctors use this information to plan treatment and to monitor progress.

Types of Treatment

Cervical cancer is treated in several ways. It depends on the kind of cervical cancer and how far it has spread. Treatments include surgery, chemotherapy, and radiation therapy.

• Surgery: Doctors remove cancer tissue in an operation.
• Chemotherapy: Using special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
• Radiation: Using high-energy rays (similar to X-rays) to kill the cancer.

Different treatments may be provided by different doctors on your medical team.

• Gynecologic oncologists are doctors who have been trained to treat cancers of a woman’s reproductive system.
• Surgeons are doctors who perform operations.
• Medical oncologists are doctors who treat cancer with medicine.
• Radiation oncologists are doctors who treat cancer with radiation.

Visit NCI for more information about treatments for cervical cancer.

Clinical Trials

Clinical trials use new treatment options to see if they are safe and effective. If you have cancer, you may want to take part. Visit the sites listed below for more information.

• NIH Clinical Research Trials and You (National Institutes of Health)
• Learn About Clinical Trials (National Cancer Institute)
• Search for Clinical Trials (National Cancer Institute)
• ClinicalTrials.gov (National Institutes of Health)

Complementary and Alternative Medicine

Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.

Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.

Which Treatment Is Right for Me?

Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.

Sometimes people get an opinion from more than one cancer doctor. This is called a “second opinion.” Getting a second opinion may help you choose the treatment that is right for you.

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