Cervical Cancer

  • Basics

    Cervical cancer begins when cells of the cervix undergo abnormal changes and begin to multiply. The cervix is the lower end of the uterus (womb) and opens to the vagina Figure 01.

    Cervical cancer is second only to breast cancer as the leading cause of cancer deaths in women worldwide. It can occur in women of any age who have reached puberty. Most cases (85% to 90%) involve the skin-like cells that cover the outside of the cervix Figure 01. These cancers are called squamous cell carcinomas. Human papilloma virus (HPV), a virus that causes genital warts, is the primary cause in more than 90% of cervical squamous cell carcinomas. In June 2006, the FDA approved a vaccine to prevent the HPV strains that cause cervical cancer, for girls and young women aged 9 to 26. The national Advisory Committee on Immunization Practices subsequently released an advisory that all girls aged 11 to 12 should routinely received the vaccine, and that girls and young women, aged 13 to 26, should receive catch-up immunization.

    The remaining 10% to 15% of cervical cancers develop in the glands that provide a mucus-like lubricant to the vagina. These tumors are called adenocarcinomas. In a few cases, a combination type of cancerous growth called adenosquamous carcinoma can occur.

    Click to enlarge: Female Reproductive Anatomy

    Figure 01. Female Reproductive Anatomy

    With early detection, especially with Pap smears, nearly every case of cervical cancer can be prevented or cured. As more girls get vaccinated, cervical cancer may eventually be virtually eliminated the US and other parts of the world with access to routine vaccination for girls.

    Full-blown cervical cancer, medically known as invasive cervical cancer, usually takes years to develop. It typically starts out as dysplasia, a precancerous condition characterized by abnormal changes in cells.

    The cellular changes cannot be seen by the naked eye and produce no symptoms. Fortunately, pelvic examinations and Pap tests (also known as Pap smears) can detect most precancerous conditions so that women can be treated before cancer develops. If left untreated, 10% to 20% of severe dysplasias will turn cancerous.

    Cervical cancer can progress to penetrate deeply into the cervix. It can also spread to other areas in the pelvis such as the bladder or rectum, and beyond to other organs.

  • Causes

    Cervical cancer occurs when cells in the cervix become abnormal and multiply out of control. These changes are often caused by human papilloma virus infection (HPV), which is most often spread as a sexually transmitted disease.

    Scientists do not know all of the reasons cervical cells turn cancerous. However, they do know that some viruses are strongly associated with the development of cervical cancer. Infection with HPV in particular can increase a woman's chance of developing cervical problems that can lead to cancer. HPV, a virus that causes genital warts, can damage the cervical cells and lead to unregulated growth of abnormal cells.

    There are many different types of HPV. Some HPV types are more likely to cause cervical cancer than others. These more harmful types are called cancer-causing (oncogenic) HPV.

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