The cervix is the lower, narrow end of the uterus (womb). Cervical cancer starts in the cells of the cervix and usually develops slowly. Before cancer appears, the cells go through changes known as dysplasia. If not destroyed or removed, the abnormal cells may become cancerous and begin to grow and spread more deeply into the cervix and surrounding area.
Cervical cancer is the third most common cancer diagnosed in Texas for women ages 20 to 39, according to the Texas Department of State Health Services (DSHS). When diagnosed early, the five-year survival rate is 92%, according to the American Cancer Society, highlighting the importance of regular screening.
A long-lasting infection with a high-risk type of the human papillomavirus (HPV) is the leading cause of cervical cancer. HPV is a common virus passed from one person to another during sexual intercourse. The Centers for Disease Control and Prevention (CDC) estimates over half of sexually active individuals will have HPV at some point in their lives.
The American Cancer Society (ACS) recommends cervical cancer screening with an HPV test every five (5) years for anyone with a cervix, beginning at age 25 until age 65. If HPV testing alone is not available, people may be screened with an HPV/Pap cotest every five (5) years or a Pap test every three (3) years.
Risk
Your physician may recommend more frequent screening if you experience the following risk factors.
- An infection from the human papillomavirus (HPV). This is the most important risk factor for cervical cancer. HPV is a group of more than 150 related viruses.
- Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body’s immune system to protect your health increases risk.
- Studies show that tobacco use, or frequent exposure to second-hand smoke, can contribute to cancer anywhere in the body.
Prevention
According to the CDC, the most important steps you can take to help prevent cervical cancer are:
- Get vaccinated against HPV.
- Receive regular screening.
- Return to the doctor if your test results are abnormal.
Preteens are recommended to receive the HPV vaccination between ages 11 to 12. If this window is missed, the vaccination may still be taken through age 26. After this age, discuss the risks and benefits with your physician.
The HPV vaccination prevents new infections but does not impact existing infections or conditions, which is why the vaccine is recommended prior to HPV exposure.
For individuals who are sexually active, condom use has been associated with a lower rate of cervical cancer.
Finally, if you smoke, quit. The CDC offers free support to help you quit smoking, including coaching sessions, a customized “quit plan,” educational materials, plus referrals to local resources. Call 1-800-QUIT-NOW (1-800-784-8669).
Symptoms
In its early stages, cervical cancer may not display symptoms, making it hard to detect. If you experience any of the following symptoms, please see a health professional. If your symptoms are due to cervical cancer, ignoring them may delay treatment or make it less effective.
Early-stage cervical cancer symptoms:
- vaginal bleeding after sex
- vaginal bleeding after menopause
- vaginal bleeding between periods or periods that are heavier or longer than normal
- vaginal discharge that is watery and has a strong odor or that contains blood
- pelvic pain or pain during sex
Advanced-stage cervical cancer symptoms (may indicate cancer has spread beyond the cervix):
- painful bowel movements or bleeding from the rectum with bowel movements
- difficult or painful urination or blood in the urine
- dull backache
- swelling of the legs
- pain in the abdomen
- fatigue
Diagnosis
The ACS recommends cervical cancer screening with an HPV test every five (5) years for anyone with a cervix, beginning at age 25 until age 65.
If HPV testing alone is not available, people may be screened with an HPV/Pap cotest every five (5) years or a Pap test every three (3) years.
Both the HPV and Pap tests require removing a small sample of cells from the cervix. Your gynecologist or other healthcare provider uses a tool called a spatula and/or a cytobrush to gently scrape or brush the cervix. The same set of cells may be used for both tests. Women who have received the HPV vaccine should still undergo screening.
- The Pap test looks for changes in the cells that might be pre-cancer or cancer.
- The HPV test looks for infection by high-risk types of HPV that have been demonstrated to cause cancer.
After age 65, the ACS says women who have had 10 years of regular screening with normal results no longer need screening for cervical cancer.
Treatment
If cancer cells are detected, consult with your primary care physician to be referred to a gynecologic oncologist, a physician trained in treating cancers of a woman’s reproductive system. Your oncologist will work with you regarding next steps.
Treatment for cervical cancer depends on its characteristics and stage, a patient’s overall health and personal goals. Options include:
- Pelvic/abdominal operation: The cancerous tissue is surgically removed.
- Radiation therapy: External beam radiation or internal radiation therapy, known as brachytherapy, can be effective treatments for cervical cancer.
- Chemotherapy: Medication is used to shrink or eliminate the cancer. The drugs can be pills you ingest or medicine injected into your veins, sometimes both.
- Immunotherapy: Additional medications may be prescribed which are designed to enhance your body’s anti-cancer immune cell response.
Sources:
American Cancer Society
National Cancer Institute
Texas Health Resources
UT Southwestern Medical Center
Texas Health and Human Services
Centers for Disease Control and Prevention
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