What is Cervical Cancer?
In 2010, there was an estimate of 12,200 new cases of cervical cancer (cancer of the cervix). Cervical cancer begins in the lining of the cervix and forms slowly. In the beginning stages, many cells begin to change from normal to pre-cancer and then to cancer. The cell changes may be called dysplasia and can be recognized by a Pap test. Cervical dysplasia may need to be treated in order to prevent cancer. There are two main types of cancer of the cervix — squamous cell carcinomas and adenocarcinomas. On occasion, the cancer has features of both called mixed carcinoma.
The increased awareness of HPV (human papillomavirus) has brought cervical cancer to the public's attention as it concentrates on young women since the virus is more common among that demographic. Overall, cervical cancer tends to occur in midlife in women younger than 50, and it rarely occurs in women younger than 20. HPV is a common virus, and many HPV infections clear naturally. If the virus does not go away on its own, the HPV-infected cells can become precancerous and can develop into an invasive cancer if left undetected and untreated. People transmit HPV through skin contact such as vaginal, anal, or oral sex, but sex is not always the culprit. HPV can be spread by skin-to-skin contact with a body area infected with the virus.
What is HPV?
- It is a very common virus.
- There are more than 100 types.
- Some types cause benign warts on the fingers or feet.
- More than 30 types can be transmitted sexually.
- About 15 sexually transmitted types, called high-risk types, can cause cervical cancer.
- Some other sexually transmitted types, called low-risk types, cause external warts on the genitals that are not cancerous.
Cervical Cancer Risk Factors
The persistent infection of HPV is one of the highest risk factors for cervical cancer. However, studies have indicated that other factors may act together with HPV to increase the risk of developing cervical cancer. Some of these risks include:
- HIV Infection (human immunodeficiency virus)
- Past, Current, or Long-Term Chlamydia Infection
- Low Fruit and Vegetable Diets
- Long-Term Use of Birth Control Pills
- Having Three or More Full-Term Pregnancies
- Low Income
- DES (diethylstilbestrol)
- Family History
Health screenings are proven to prevent cervical cancer in order to find and treat pre-cancer stopping the cancer before it starts.
- The Pap test (or Pap smear) and pelvic exams are common ways to detect precancerous cells.
- The Pap test should be administered about three years after a woman begins having vaginal intercourse.
- The Pap test should be done every year if the regular Pap test is used or every two years if the liquid-based Pap test is used.
- A HPV DNA test can be used as a screening test in women over 30, but it does not replace the Pap test.
- Waiting to have sex until you are older will limit the number of people you have sex with as well as avoid having sex with someone who has had numerous sex partners.
- Using condoms can help protect against HPV.
- Do not smoke.
- Receiving the HPV vaccines (Gardasil® and Cervarix®) can protect against certain types of HPV. These vaccines are used only to prevent and not to treat and are given in a series of three injections over six months.
Early stages of pre-cancers or cancers many times do not have signs or symptoms. For this reason, regular Pap tests are important. You should report to your doctor right away if you have experienced any of the following:
- Abnormal vaginal bleeding
- Unusual vaginal discharge
- Pain during sex
The stage of your cancer will determine your treatment options. Your age, overall health, and personal preferences can impact your treatment decision. Many times getting a second opinion is recommended because you tend to receive more information as well as feel better about treatment options. Follow the link for more information on cervical cancer treatment.
If you have ever received an abnormal Pap test, you may find these tables from the National Cancer Institute helpful.
- Table 1 — What Your Pap Test/HPV Results Mean and Follow-Up
- Table 2 — Tests or Follow-Up Treatments That Health Care Providers Use for Abnormal Pap Tests
- Table 3 — What Does It Mean: Results From Your Biopsy or Endocervical Curettage
- Table 4 — Treatments for Major Cell Changes
For information, please visit the Vanderbilt-Ingram Cancer Center's Patient and Family Resource Center located in The Vanderbilt Clinic.
If you are a cervical cancer survivor, we encourage you to participate in the Vanderbilt REACH for Survivorship Program, which is a collaboration of the Vanderbilt-Ingram Cancer Center, the Monroe Carell Jr. Children's Hospital at Vanderbilt and the Vanderbilt Department of Pediatrics.