Cervical cancer occurs in the cells of the cervix, which is the lower part of the uterus. Cervical cancer starts in the cervix lining, and most cancers begin in the transformational zone. The human papillomavirus (HPV), a sexually transmitted infection plays a role in causing most cervical cancer.
Symptoms of cervical cancer
Like other types of cancer, you can hardly detect cervical cancer in the early stages. Patients start noticing symptoms when the tumour has already grown and spread to surrounding tissues or organs. Cervical cancer symptoms include:
- Abnormal vaginal discharge
- Longer or heavier menstruation
- Pain during sexual intercourse
- Irregular bleeding in the vagina after periods, sexual intercourse, menopause, or after a pelvic exam
- Vaginal discharge with foul smell
- Trouble urinating
- Leaking urine and faeces
- Loss of appetite
- Loss of weight
- Swollen legs or one leg
- Lower back pain or in the pelvic area
- Fatigue
- Pain in the bones
- Chest pain
Types of cervical cancer
1. Squamous cell cervical carcinoma
This type of cervical cancer occurs in the cells in the lower part of the cervix. Squamous cell carcinoma is the most common type of cervical cancer.
2. Adenocarcinoma
AdenocarcinomaThe cancer develops in glandular cells lining the cervical canal. The glandular cells have a column-like shape, and they produce mucus in the endocervix.
3. Less common cervical cancers
Sometimes cervical cancers involve both cells, giving them the names mixed carcinomas or adenosquamous carcinomas. They have features of both types of cervical cancer. Other rare cancers that occur in the cervix include lymphoma, melanoma, and sarcoma. However, these cancer types mainly happen in different body parts and rarely occur in the cervix.
Precancerous conditions and causes of cancer
Precancerous conditions refer to the change of cells in the cervix from usual to abnormal cells, but these cells are not yet cancerous. The precancerous conditions are classified into:
- Squamous intraepithelial lesion (SIL)
- Cervical intraepithelial neoplasia (CIN)
- Cervical dysplasia
Screening of these pre-cancers helps with determining the possible danger that they pose. If the screening qualifies the pre-cancer cells as either CIN1, mild dysplasia, or low-grade SIL, then it’s not considered very serious. Screening results that classify the pre-cancers as CIN2 or CIN3, moderate or severe dysplasia, or high-grade SIL indicate a greater danger of becoming cancerous cells.
The most common risk factor associated with the formation of cervical cancer is Human papillomavirus (HPV). Humans have some genes known as tumour suppressor genes which regulate the growth of cells. HPV has two proteins, E6 and E7, that turn off some genes that suppress tumour growth. In some cases, the presence of HPV allows the growth of cancerous cells. However, although many women get HPV, it doesn’t always lead to cervical cancer.
Testing for cervical cancer
Doctors conduct a pap test where they scrap some cells from the cervix and test them for any abnormalities. If the doctor suspects cervical cancer an extensive examination of the cervix is done including a biopsy. Imaging by X-rays, CT scans, MRI, and PET scans follow to determine the extent of cancer so as to determine the treatment plan.
Risk factors for cervical cancer
Several factors increase the chances of getting cervical cancer. These include:
1. Human papillomavirus infection (HPV infection)
HPV has over 150 related viruses which cause different diseases. Low-risk types of HPV cause warts on or in the areas surrounding the vagina, anus, or male genitalia. High-risk types of HPV cause cancer in the cervix, vagina, vulva, anus, or penis. They can also cause cancers in the mouth and throat. HPV is transmitted through skin-to-skin contact during sexual intercourse or oral sex. Sometimes HPV infections can clear on their own. At the moment, there’s no known treatment for HPV, but HPV vaccines can help prevent some diseases linked to HPV.
2. Sexual activity.
- Having many sexual partners increases the chances of getting an HPV infection.
- Engaging in sexual activities at an early age increases the exposure chances to HPV.
- Engaging in sexual intercourse with one person who has a HPV infection or is at risk of exposure due to multiple sexual partners.
3. A weakened immune system
The chances of developing cervical cancer are higher when you have HPV and a condition that affects your immune system, such as HIV.
4. Smoking
Smoking is a risk factor for many types of cancer. It can lead to the absorption of chemicals which cause cancer. Research indicates that women who smoke have higher chances of developing cancer of the cervix.
5. Other STIs
Sexually transmitted infections such as gonorrhoea, syphilis, Chlamydia, and HIV increase the risk of HPV infections. In particular, the presence of Chlamydia bacteria in the cervix fosters the growth of HPV and increases the risk of developing cancer.
6. Diethylstilbestrol (DES)
Diethylstilbestrol (DES) is a miscarriage prevention drug given to women between 1938 and 1971. DES caused clear-cell adenocarcinoma of the cervix or vagina in women who took the pill while pregnant. The FDA stopped the drug in 1971, and this type of cancer is not common in women who didn’t take the hormonal medication.
7. Family history of cervical cancer
A family history of cervical cancer increases the chances of developing this type of cancer. There may be genetic and non-genetic factors that make it difficult to fight off HPV infections.
Prevention of cervical cancer
While preventing cervical cancer entirely may not be possible, you can reduce the chances of developing it by practising safe sex, having routine pap smears, avoiding smoking, and getting a HPV vaccine if applicable.
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