Cervical cancer is the cancer of the lower part (neck) of the uterus. It starts when the cells lining the cervix begin to develop abnormal changes. Over time, these abnormal cells may become cancerous.

Worldwide, cervical cancer constitutes 4% of all cancers diagnosed and is still on the rise especially in developing countries.

Types of cervical cancer

There are two main types of cervical cancer: the squamous cell carcinoma and adenocarcinoma. Each type is defined by the cell that is affected and distinguished by the appearance of the cells when viewed under a microscope.

Squamous cell carcinoma: This type account for about 80 to 90% of cervical cancer cases. These cancers begin in the thin, flat cells that line the bottom of the cervix (called exocervix) and the cancer cells have features of squamous cells under the microscope.

Adenocarcinomas:  This type accounts for 10 to 20% of cervical cancer cases. It develops in the glandular cells that line the upper portion of the cervix (called endocervix).

In rare cases, the two types of cells are involved with the cancer having features of both squamous cell carcinomas and adenocarcinomas. These are called adenosquamous carcinomas or mixed carcinomas.

Other types of cancer which can occur in the cervix are melanoma, sarcoma, and lymphoma. Their occurrence is very rare but occurs more commonly in the other parts of the body.

Causes of cervical cancer

The known primary underlying cause is the human papilloma virus (HPV), which is the most common sexually transmitted infection worldwide. Other risk factors reported in the patients include;

  • poverty and low socio-economic status
  • grand multi-parity( having more than 5 children)
  • Early age at onset of sexual intercourse
  • Multiple sex partners
  • Smoking cigarettes
  • Prolonged use of oral contraceptive pill

Symptoms of cervical cancer

Documented clinical features include:

  • Abnormal vaginal bleeding (such as spotting between regular menstrual periods, after sexual intercourse, after menopause)
  • Heavy vaginal discharge that may be watery, thick, or offensive
  • Frequent urination and pain during urination
  • Pain on pelvic side wall.
  • Pain during sexual intercourse

 

 

In advanced disease state, symptoms also include:

  • Weight loss
  • Backache
  • Leg pain
  • Haematuria (blood in urine).

Stages of cervical cancer

Five stages used to describe cervical cancer progression include:

Stage 0: Abnormal cells which could become cancerous are found in the inner lining of the cervix

Stage I: Cancer is found in the cervix only

Stage II: The caancer has spread through the uterus upto the upper part of the vagina

Stage III: The cancer has spread outside the uterus, to the vagina and the pelvic wall. At this stage, it could be large enough to cause obstruction to the urinary system causing kidney dysfunction

Stage IV: The cancer has spread to the surrounding tissues like the bladder, rectum and the other parts of the body.

Prevention of cervical cancer

Cancer of the cervix is a preventable disease. Prevention of cancer of the cervix is achievable by:

  • Preventing Human papilloma virus infection. This can be achieved by avoiding multiple sex partners and correct and consistent use of condom.
  • Vaccination is also an effective way of preventing cervical cancer. Human papilloma virus vaccine is recommended for girls’ 11-12years who are not sexually active yet, but female 13-25years can also benefit from the vaccine.
  • Ensuring early detection and treatment can significantly reduce morbidity and mortality.

 

 

 

 

 

 

Diagnosis of cervical cancer

 

  • Pap smear test is one of the most reliable and effective cervical cancer screening tests available.
  • A screening test for cervical precancerous and cancerous lesions using visual inspection aided by acetic acid is also available.
  • Human papillomavirus test is done if pap smear result shows abnormal cell to ascertain the type of Human papillomavirus involved.
  • Biopsy may also be done if abnormal cells are seen in pap test.

 

 

Treatment of cervical cancer

Treatment and its outcome depend on certain factors such as; the stage when the cancer is detected, the type of cancer, the age and the general health of the individual. Majorly, standard treatments include:

 

  • Surgery: Surgical removal of the abnormal cells or in the advanced stage removal of the entire uterus. This method is used mostly for those who don’t desire to have children again.
  • Chemotherapy: Use of cytotoxic drugs that stops the growth of the cancer cells
  • Radiotherapy: Use of radiations to kill the cancer cells or to stop them from growing
  • Targeted therapy: Targeting the abnormal cells thereby sparing the healthy and normal cells.

 

Article by: eDokita Team

 

Reference

  1. Center for Disease control and prevention. Global cancer statistics. 2016. Web:
  1. American Cancer Society. What is cervical cancer? Web
  1. PDQ® Adult Treatment Editorial Board. PDQ Cervical Cancer Treatment. Bethesda, MD: National Cancer Institute. 2016.

WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). “Human Papillomavirus and Related Cancers in World”.  2010.