Cervical cancer is where
malignant (cancer) cells form in the tissues of the cervix.
The cervix is the lower, narrow end of the uterus (the
hollow, pear-shaped organ where a fetus grows). The cervix leads from the
uterus to the vagina (birth canal).
Cervical cancer usually develops slowly over time. Before
cancer appears in the cervix, the cells of the cervix go through changes
known as dysplasia, in which cells that are not normal begin to appear in
the cervical tissue. Later, cancer cells start to grow and spread more
deeply into the cervix and to surrounding areas.
Human papillomavirus (HPV) infection
is the major risk factor for development of cervical cancer.
Infection of the cervix with human papillomavirus (HPV) is
the most common cause of cervical cancer. Not all women with HPV
infection, however, will develop cervical cancer. Women who do not
regularly have a Pap smear to detect HPV or abnormal cells in the cervix
are at increased risk of cervical cancer.
Other possible risk factors include the following:
- Giving birth to many children.
- Having many sexual partners.
- Having first sexual intercourse at a
- Smoking cigarettes.
- A diet lacking in vitamins A and C.
- Oral contraceptive use ("the
- Weakened immune system.
There are usually no noticeable signs of
early cervical cancer but it can be detected early with yearly check-ups.
Early cervical cancer may not cause noticeable signs or
symptoms. Women should have yearly check-ups, including a Pap smear to
check for abnormal cells in the cervix. The prognosis (chance of recovery)
is better when the cancer is found early.
Possible signs of cervical cancer
include vaginal bleeding and pelvic pain.
These and other symptoms may be caused by cervical cancer
or by other conditions.
A doctor should be consulted if any of the following
- Vaginal bleeding.
- Unusual vaginal discharge.
- Pelvic pain.
- Pain during sexual intercourse.
Tests that examine the cervix are used
to detect (find) and diagnose cervical cancer.
The following procedures may be used:
- Pap smear: A procedure to collect cells
from the surface of the cervix and vagina. A piece of cotton, a brush,
or a small wooden stick is used to gently scrape cells from the cervix
and vagina. The cells are viewed under a microscope to find out if
they are abnormal. This procedure is also called a Pap test.
- Colposcopy: A procedure to look inside
the vagina and cervix for abnormal areas. A colposcope (a thin,
lighted tube) is inserted through the vagina into the cervix. Tissue
samples may be taken for biopsy.
- Biopsy: If abnormal cells are found in a
Pap smear, the doctor may do a biopsy. A sample of tissue is cut from
the cervix and viewed under a microscope. A biopsy that removes only a
small amount of tissue is usually done in the doctors office. A
woman may need to go to a hospital for a cervical cone biopsy (removal
of a larger, cone-shaped sample of cervical tissue).
- Pelvic exam: An exam of the vagina,
cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or
nurse inserts one or two lubricated, gloved fingers of one hand into
the vagina and the other hand is placed over the lower abdomen to feel
the size, shape, and position of the uterus and ovaries. A speculum is
also inserted into the vagina and the doctor or nurse looks at the
vagina and cervix for signs of disease. A Pap test or Pap smear of the
cervix is usually done. The doctor or nurse also inserts a lubricated,
gloved finger into the rectum to feel for lumps or abnormal areas.
- Endocervical curettage: A procedure to
collect cells or tissue from the cervical canal using a curette
(spoon-shaped instrument). Tissue samples may be taken for biopsy.
This procedure is sometimes done at the same time as a colposcopy.
Certain factors affect prognosis (chance
of recovery) and treatment options.
The prognosis (chance of recovery) depends on the
- The stage of the cancer (whether it
affects part of the cervix, involves the whole cervix, or has spread
to the lymph nodes or other places in the body).
- The type of cervical cancer.
- The size of the tumor.
- Treatment options depend on the following:
- The stage of the cancer.
- The size of the tumor.
- The patient's desire to have children.
- The patients age.
Treatment of cervical cancer during pregnancy depends on
the stage of the cancer and the stage of the pregnancy. For cervical
cancer found early or for cancer found during the last trimester of
pregnancy, treatment may be delayed until after the baby is born.
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