Cervical cancer
The cervix is known as the neck of the womb and is a narrow muscular opening connecting the vagina to the womb (uterus). Cancer can affect any part of the cervix.
Cervical cancer is most commonly caused by certain strains of a virus called the Human Papilloma Virus (HPV).
The risk of cervical cancer has been much reduced with both the US’s cervical screening program and the HPV vaccination program. It's a relatively uncommon cancer but receives a lot of attention as it is so easily prevented if early cell changes are caught and because it affects young women who are otherwise healthy and at low risk of other cancers.
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What causes cervical cancer?
HPV is the biggest risk factor in developing cervical cancer. It’s a very common virus, contracted through any sexual or genital contact, including oral and anal sex, sharing sex toys, or any genital skin-to-skin contact.
It should carry no embarrassment or shame; you can contract it if you've had one sexual partner or lots or if you are in a same-sex or opposite-sex relationship. You or your partner won’t have symptoms, and your body can naturally clear HPV with time.
Certain strains of HPV cause changes to cervical cells that are considered pre-cancerous. If left untreated, over months to years, they can develop into cancer cells.
Can I prevent it?
Both girls and boys aged 11 to 12 should be offered an HPV vaccine. This is hopefully before they become sexually active, to prevent them from getting HPV in the first place.
The cervical screening program is offered to all women aged 21 to 64. The smear test or pap test takes a sample from the cervix, looking for the presence of HPV and, if present, any changes to cells (dysplasia).
If found, treatment is offered in a procedure called a colposcopy to remove the area of abnormal cells, thus preventing cancer. Research suggests that 99.8% of cervical cancers are preventable.
Smoking puts you at a higher risk of cervical cells becoming abnormal. It’s also thought to reduce the chance of your immune system being able to clear HPV from your body. Up to 21% of cervical cancers are related to smoking.
When should I see my doctor?
Cervical cancer is slow-growing, so the best you can do is maintain your cervical screening appointments when due. This is a pap test every 3 years.
If you develop symptoms at any point, it’s best if you don’t wait for your next smear test, book an appointment with your doctor. Symptoms include pain during sex, bleeding after sex or between periods, or unusual or bloody discharge. There can be a number of causes for this, and your doctor will ask about your symptoms, your smear test history, and other relevant factors. They will ask you for permission to perform an internal examination.
They can refer you urgently to a specialist team if they have concerns about cervical cancer.
How is it treated and what’s the outcome?
If your smear test shows abnormal cells, your doctor will refer you for a procedure called a colposcopy. The area of abnormal or pre-cancerous cells can be treated in a number of ways, and treatment is usually definitive. You will be followed up with a smear test, usually 6 months later, and you will have smear tests more often for a few years.
If the clinician finds cervical cancer, treatment options depend on the grade of cancer and spread to other organs and your general health. It may be treated with surgery, radiotherapy, chemotherapy, targeted medicines, or a combination.
Treatment may have implications for your fertility and ability to carry a baby. The team in charge of your care will discuss the risks and options with you.
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