Cancer of the cervix, also called cervical cancer, is cancer that occurs when cells lining the cervix, the lower part of the uterus (womb), develop abnormally and grow out of control.
The most common types of cancer of the cervix are:
- Squamous cell carcinoma
- This is the most common type of cancer of the cervix, accounting for up to 90% of cases
- These cancers develop from cells in the exocervix, the outer part of the cervix that can be seen by a doctor during a speculum exam
- Squamous cell carcinomas usually originate in the transformation zone, where the exocervix joins the endocervix (the opening of the cervix that leads into the uterus)
- Adenocarcinoma
- Most of the remainder of cancers of the cervix are adenocarcinomas called adenosquamous carcinomas or mixed carcinomas that develop from the mucus-producing gland cells of the endocervix
- Other types of cervical cancer
What Are Symptoms of Cancer of the Cervix?
Cancer of the cervix (cervical cancer) often does not have symptoms in the early stages. Symptoms of cancer of the cervix usually do not start until the cancer grows and spreads (metastasizes) into nearby tissue. When symptoms of cancer of the cervix occur, they may include:
- Abnormal vaginal bleeding
- Unusual vaginal discharge
- May occur between periods or after menopause
- May contain blood
- Pain in the pelvic region
- Pain during sex
Symptoms of advanced cervical cancer may include:
- Problems urinating or having a bowel movement
- Leg swelling
- Blood in the urine
What Causes Cancer of the Cervix?
The cause of cancer of the cervix (cervical cancer) is often unknown but it is believed it may be due to genetic changes (mutations).
Some types of human papillomavirus (HPV) infection are the biggest risk factor for cervical cancer.
In addition to HPV infection, risk factors for developing cervical cancer include:
- Sexual history
- Becoming sexually active before 18 years old
- Many sexual partners
- A partner who is considered high risk (someone with HPV infection or who has many sexual partners)
- Chlamydia infection
- A weakened immune system such as from human immunodeficiency virus (HIV) or taking immunosuppressant drugs
- Smoking
- Family history of cervical cancer
- Long-term use of oral contraceptives (birth control pills)
- Age younger than 20 years at first full-term pregnancy
- Having multiple (3 or more) full-term pregnancies
- A diet low in fruits and vegetables
- Economic status
- Low-income women may not have easy access to some health care services, including cervical cancer screening with Pap tests and HPV tests, which means they may not get screened or treated for cervical pre-cancers
- Use of diethylstilbestrol (DES)
How Is Cancer of the Cervix Diagnosed?
Cancer of the cervix (cervical cancer) is diagnosed with regular screenings.
- A Pap smear (Pap test) is a test that collects cells from the cervix to check for abnormal cervical cells that can lead to cervical cancer
- Pap tests are also used to find abnormal cervical cells before they become cancer (precancers)
- The HPV test is usually used in 2 situations:
- The primary HPV test is preferred for cervical cancer screening in women age 25-65 years
- Some HPV tests are part of a co-test, when the HPV test and the Pap test are done at the same time to screen for cervical cancer
What Is the Treatment for Cancer of the Cervix?
Treatments for cancer of the cervix (cervical cancer) may include one or more of the following:
- Surgery
- For pre-cancer:
- Ablation to destroy cervical tissue with cold temperatures (cryosurgery) or a laser
- Excisional surgery (conization) to cut out and remove the pre-cancer
- For invasive cervical cancer:
- Hysterectomy (simple or radical) to remove the cervix and uterus
- Trachelectomy to remove the cervix and the upper part of the vagina but not the body of the uterus for women who want maintain the ability to have children
- Lymph node removal
- For pre-cancer:
- Radiation therapy
- Chemotherapy (“chemo”)
- For cervical cancer that has come back or spread to other areas:
- Chemoradiation, which is chemotherapy given along with radiation to help it work better
- Targeted therapy
- Immunotherapy
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