Robert Wood Johnson University Hospital
 

Cervical Cancer

Cervical Cancer

Illustration of the anatomy of the female pelvic area
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What is the cervix?

The cervix is the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.

What are precancerous conditions of the cervix?

Precancerous conditions of the cervix are identified as cells that look abnormal, but are not cancerous at the present time. However, the appearance of these abnormal cells may be the first evidence of cancer that develops years later.

Precancerous changes of the cervix usually do not cause pain and, in general, do not cause any symptoms. They are detected with a pelvic exam or a Pap test.

Squamous intraepithelial lesions (SIL) is a term that refers to abnormal changes in the cells on the surface of the cervix:

Chlamydia and cervical cancer

Research has shown that chlamydia, the most common sexually transmitted disease in the U.S., may increase a woman's risk of developing cervical cancer. In the study, published in the Journal of the American Medical Association, women who showed signs of any type of chlamydial infection in their blood were two-and-a-half times more likely to develop cervical cancer, when compared to women with no sign of infection. Although the reason for this increased risk is still under investigation, researchers speculate that immune system cells that are activated at chlamydia infection sites may damage normal cells.

According to the National Cancer Institute, changes in these cells can be divided into two categories:

What is cancer of the cervix?

If abnormal cells on the surface of the cervix spread deeper into the cervix, or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. Cervical cancer occurs most often in women younger than the age of 50. It is different from cancer that begins in other parts of the uterus and requires different treatment. Most cervical cancers are squamous cell carcinomas and adenocarcinomas.

The mortality rates for cervical cancer have declined sharply as Pap screenings have become more prevalent. According to the American Cancer Society about 12,170 cases of invasive cervical cancer will be diagnosed in the U.S. during 2012. Some researchers estimate that noninvasive cervical cancer (also referred to as carcinoma in situ) is nearly four times more common than invasive cervical cancer.

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases, including cancers, have different risk factors.

Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop cancer, while others develop cancer and have no known risk factors.

But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

What are risk factors for cervical cancer?

The following have been suggested as risk factors for cervical cancer:

Can cervical cancer be prevented?

Early detection of cervical problems is the best way to prevent cervical cancer. Routine, annual pelvic exams and Pap tests can detect precancerous conditions that often can be treated before cancer develops. Invasive cancer that does occur would likely be found at an earlier stage. Pelvic exams and Pap tests are used to determine if there are cervical problems. Women who are age 21 or older should have regular checkups, including a pelvic exam and Pap test.

According to the National Institutes of Health:

A pelvic exam and Pap test allow the doctor to detect abnormal changes in the cervix. If an infection is present, it is treated and the Pap test is repeated at a later time. If the exam or Pap test suggests something other than an infection, a repeated Pap test and other tests are performed to determine the problem.

Women who have had a hysterectomy (surgery to remove the uterus, including the cervix) should ask their doctor's advice about having pelvic exams and Pap tests.

Because certain strains of HPV have been found to cause most cases of cervical cancer, research efforts have focused on developing a vaccine against HPV. Two HPV vaccines have been approved:

These vaccines can only be used to prevent certain types of HPV infection before a person is infected. They cannot be used to treat an existing HPV infection.

Both vaccines are administered as a series of three injections over a six-month period. To be most effective, one of the vaccines should be given before a person becomes sexually active.

What are the symptoms of cervical cancer?

Symptoms of cervical cancer usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue:

The symptoms of cervical cancer may resemble other conditions or medical problems. Consult a doctor for diagnosis.

How is cervical cancer diagnosed?

When cervical problems are found during a pelvic examination, or abnormal cells are found through a Pap test, a cervical biopsy may be performed.

There are several types of cervical biopsies that may be used to diagnose cervical cancer, and some of these procedures that can completely remove areas of abnormal tissue may also be used for treatment of precancerous lesions. Some biopsy procedures only require local anesthesia, while others require a general anesthesia. Several types of cervical biopsies include:

Treatment for cervical cancer

Specific treatment for cervical cancer will be determined by your doctor based on:

Treatment may include:

LEEP or conization may also be used to remove abnormal tissue.

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Online Resources of Gynecological Health

 

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