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(Cancer of the Cervix)
Cervical cancer is a disease in which cancer cells grow in the cervix. The cervix is the lower, narrow part of the uterus. It connects the uterus with the vagina.
Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
Research suggests that some sexually transmitted infections such as human papillomavirus (HPV), can cause cervical cells to begin the changes that can lead to cancer.
It is not clear exactly what causes changes in the cells, but is probably a combination of genetics and environment.
Risk Factors TOP
Cervical cancer is more common in women over 25 years old. Other factors that may increase your chances of cervical cancer:
Symptoms usually do not appear until the abnormal cells become cancerous. Then, they invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may include:
There may also be pelvic discomfort or a backache.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. This will include an examination of the vagina and cervix.
Tests may include:
Imaging tests may include:
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, cervical cancer is staged from 1-4. Stage 1 is a very localized cancer, while stage 4 indicates a spread to other parts of the body.
Treatment depends on the stage of the cancer and may include:
The cancerous tumor, nearby tissue, and possibly nearby lymph nodes may be removed. The doctor may remove only the tumor and nearby normal tissue if the tumor is contained within the cervix. In some cases, a hysterectomy is necessary.
If the cancer is at a later stage, more tissue must be removed. This may include the ovaries and fallopian tubes.
Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. Radiation may be given in two ways:
Chemotherapy is the use of toxic drugs to kill cancer cells. It may be given in many forms, including: pill, injection, or through an IV. The drugs enter the bloodstream and travel through the body. It kills mostly cancer cells, but also some healthy cells. Chemotherapy alone rarely cures cervical cancer. It may be used with surgery and/or radiation.
This therapy may also be used to help control pain and bleeding when a cure is no longer possible.
Finding and treating precancerous tissue in the cervix is the best way to prevent cervical cancer. Talk to your doctor about when you should have Pap tests done. Another good approach is to reduce your risk of exposure to the HPV virus. There are currently 2 methods to do this:
The Pap test is used to screen for cervical cancer. It is also used to detect cervical dysplasia. A sample of cells is collected from the cervix to be tested. HPV can also be screened by testing the same sample of cells.
If you are a healthy woman, many professional health organizations offer these recommendations for screening:
Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, like a weak immune system or a history of cervical dysplasia or cervical cancer. Talk to your doctor about the right screening schedule for you.
American Cancer Society
National Cancer Institute
Canadian Cancer Society
Cervical cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/cervical-cancer.html. Accessed January 29, 2018.
Cervical cancer. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/cancer/cervical. Updated January 2, 2018. Accessed January 29, 2018.
Cervical cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114831/Cervical-cancer . Updated June 5, 2017. Accessed January 29, 2018.
Committee on Practice Bulletins—Gynecology. Practice Bulletin No. 168: cervical cancer screening and prevention. Obstet Gynecol. 2016;128(4):e111-e130. Reaffirmed 2017.
General information about cervical cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/cervical/patient/cervical-treatment-pdq. Updated October 13, 2017. Accessed January 29, 2018.
Human papillomavirus (HPV) vaccines. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet. Updated November 22, 2016. Accessed January 29, 2018.
Immunization schedules. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/vaccines/schedules/index.html. Updated February 6, 2017. Accessed January 29, 2018.
Practice Bulletin No. 183 summary: postpartum hemorrhage. Obstet Gynecol. 2017;130(4):923-925.
Saslow D, Soloman D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147-172.
Sawaya GF. Cervical-cancer screening: new guidelines and the balance between benefits and harms. N Engl J Med. 2009;361(26):2503-2505.
5/18/2007 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T908142/Human-papillomavirus-HPV-vaccine : The FUTURE II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med. 2007;356:1915-1927.
7/7/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116761/Cervical-cancer-screening : Qaseem A, Humphrey LL, et al. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(1):67-72.
10/1/2014 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T576498/Complications-of-obesity : Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.
Last reviewed November 2018 by
EBSCO Medical Review Board
Mohei Abouzied, MD, FACP
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