The Facts About Cervical Cancer

Cervical cancer is easily preventable with regular Pap tests. What are the signs of cervical cancer, who does it affect and what are the treatment options?

It is the fourth most frequently diagnosed cancer among women, according to the World Health Organization (WHO), with 640,000 new diagnoses and around 342,000 deaths globally in 2020.

Cervical cancer is the growth of abnormal cells in the cervix, or entryway into the uterus, or womb. There are two main types of cervical cancer and a combination of the two chief kinds.

Squamous cell carcinoma

Squamous cell carcinoma occurs in the thin and flat cells, or squamous cells, lining the outer part of the cervix that heads into the vagina, according to the Mayo Clinic.

This kind of cancer is caused by infection from high-risk Human Papilloma Virus (HPV) serotype-16 and 18, according to the National Library of Medicine (NIH).

The majority of cervical cancers are squamous cell carcinoma, averaging roughly 9 out of 10 cases, the American Cancer Society shared.

Adenocarcinoma

This type of cervical cancer forms in mucus-producing or glandular cells of the body, or the upper mucus-lined part of the cervix. A 2016 study suggested screening may be hard to prevent adenocarcinoma. However, it is helpful in detecting Stage 1A adenocarcinoma.

Adenosquamous carcinomas or mixed carcinomas

Sometimes someone will have a combination of characteristics of squamous cell carcinoma and adenocarcinoma.

The problem with cervical cancer is the same as other cancers in different parts of the body. Early cervical cancer often does not cause any symptoms at all. Most diagnoses are made after someone has advanced cervical cancer.

For the most part, the symptoms of cervical cancer include the following:

• Bleeding from the vagina outside of your period
• Heavier and longer menstrual bleeding
• Pain during penetrative intercourse
• Bleeding after intercourse
• Constant pelvic pain
• Changes to one's vaginal discharge, such as increased amounts or a change in smell or appearance
• Vaginal bleeding after menopause

There are more than 100 types of HPV, according to the Food and Drug Administration (FDA), but not every strain affects the genitals. Most problems occur due to HPV types 6, 11, 16 or 18. The median age of diagnosis in women and people assigned female at birth (AFAB) is around 49, though it may affect younger, pre-menopausal women.

As virtually all cases of cervical cancer are caused by persistent infection with high-risk forms of the human papillomavirus, it would be easy to assume that all women could fall prey to the disease.

However, this is only partly true. Although 8 out of 10 women may find themselves infected with genital HPV at some point, most won't get cervical cancer, according to the NIH MedlinePlus Magazine.

Those who may be at a higher risk of developing cervical cancer include people:

• Who are active smokers or those often exposed to secondhand smoke
• Immunocompromised and have a weakened immune system, such as people with lupus, fibromyalgia or human immunodeficiency virus, or HIV
• Those who have multiple sexual partners without using condoms (it is unknown how well condoms protect against HPV)
• Those born to mothers who used diethylstilbestrol (DES), a synthetic form of estrogen, during their pregnancies in the period running from 1939 to 1971
• Who have HPV and have been on hormonal contraception for five years or more, although choosing contraception based on a slight cancer risk is not recommended

Screening for cervical cancer involves regular Pap smear tests, pelvic exams and a colposcopy to look for abnormal tissue in the event of an abnormal Pap test result.

Some women avoid the process altogether as it causes them to feel embarrassment, discomfort or pain. Over 8 million women aged 21 to 65 hadn't been screened for cervical cancer in the previous five years, according to 2014 CDC data.

It's now recommended that cervical cancer screening with an HPV test occurs every five years beginning at age 25 until age 65. If HPV testing alone is not available, consider an HPV and Pap cotest every five years or a Pap test every three years, the ACS stated.

There are multiple ways to perform a screening. These include

• Pap smear tests: to look for precancerous cells that could become cancerous or cervical cancer
• HPV-DNA: to detect high-risk strains of HPV
• HPV mRNA: to detect HPV infections that could eventually lead to the malignant transformation of cells

DNA testing is the go-to screening method to help prevent cervical cancer, as recommended by the WHO. However, to confirm the diagnosis of cervical cancer in a patient, additional tests such as a cone biopsy or a large-loop excision may be required.

Cervical cancer treatment depends on what stage the cancer is in and the size of the tumor found in the patient.

Treatment options include:

• In the case of small tumors, a cone biopsy is mandated for their removal. However, in cases where the tumors may be deeply rooted, a physician may call for a full hysterectomy
• For medium-sized tumors and locally-advanced cases, radiation therapy paired with the use of cisplatin chemotherapy is necessary for killing cancer cells
• For widespread metastasized cervical cancer, a more potent mixture of platinum and fluorouracil will be used for chemotherapy or, in the worst cases, palliative or hospice care to make the patient more comfortable

Preventing cervical cancer is possible. Ways to help reduce the risk of cervical cancer include:

• HPV screening beginning at the age of 30 for those in good health and from 25 for those living with HIV, with follow-up screenings as determined by your physician
• Getting the HPV vaccine
• Quitting smoking or avoiding areas with excessive secondhand smoke
• Practicing safer sex

What are the five warning signs of cervical cancer?

The five most common warning signs of this cancer include the following:

• Pain during penetrative intercourse
• Bleeding after intercourse
• Pelvic pain
• Vaginal discharge changes
• Vaginal bleeding after menopause

Can cervical cancer be cured?

When cervical cancer is detected in the early stages, it is especially treatable and curable.

Can you die from cervical cancer?

Death from cervical cancer isn't inevitable, especially if the diagnosis was made early enough. The survival rate for all cervical cancer patients is roughly 67 percent, according to the National Cancer Institute.

Depending on the stage in which the disease is diagnosed, the five-year survival rate may be presented as:

• Early stage or non-metastasized cancer at 92 percent
• Cancer that has spread to nearby organs and lymph nodes at 59 percent
• Cancer that has spread to more distant organs like the lungs or brain at 17 percent