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More Facts About Cervical Cancer
By peace | July 15, 2006
Cervical cancer is a major health problem in the world today. In some developing countries it is the commonest female cancer. It is estimated that around 370,00 cases of cervical cancer are diagnosed in the world each year. In the UK the situation continues to improve. In 1997 there were 2,740 cases of cervical cancer in England and Wales with 1,222 women dying of this disease. This represents a death rate of around 4 per 100,000. This compares with a death rate in 1979 of 7 per 100,000, which is an improvement of over 40%.
Incidence And Prevalence
Cancer of the cervix is the second most common cancer in women worldwide and is a leading cause of cancer-related death in women in underdeveloped countries. Worldwide, approximately 500,000 cases of cervical cancer are diagnosed each year.
Routine screening has decreased the incidence of invasive cervical cancer in the United States, where approximately 13,000 cases of invasive cervical cancer and 50,000 cases of cervical carcinoma in situ (i.e., localized cancer) are diagnosed yearly.
Invasive cervical cancer is more common in women middle aged and older and in women of poor socioeconomic status, who are less likely to receive regular screening and early treatment. There is also a higher rate of incidence among African American, Hispanic, and Native American women.
Invasive cancer of the cervix occurs when abnormally dividing cells, which arise in the outer layer (or epithelium), invade into the deeper tissue layers. The resulting mass (or tumour) of invading cells continues to divide and enlarge as it invades the surrounding tissue. Cells may break off from the primary tumour and spread (or metastasise) via the lymphatic or blood vessels to distant sites. The size and degree of invasion of the cancerous tissue will determine the stage of the disease. Accurate staging of cervical cancer is vital in determining the optimum treatment.There are two main types of cervical cancer; cancers arising from squamous epithelium (squamous carcinoma), which covers the outer cervix i.e. that portion which protrudes into the vagina, and glandular cancers (adenocarcinoma) arising from the gland bearing epithelium of the cervical canal (leading up to the cavity of the uterus). Squamous cancers are the most common type of cancer of the cervix and it is this type of cancer that the cervical screening programme is specifically designed to prevent, although adenocarcinoma may also be detected/prevented by cervical smears.
Cervical cancer is a disease of young women and most commonly occurs around the mid 40’s. It can affect a wide age range and women in their 20’s may develop the disease.
Causes and Risk Factors Of Cervical Cancer
The cause of cervical cancer is unknown. Infection with two types of human papillomavirus (HPV), which is transmitted sexually, is strongly associated with cervical and vulvar cancer and is the primary risk factor. Evidence of HPV is found in nearly 80% of cervical carcinomas. Human Immunodeficiency Virus (HIV) infection reduces the immune system’s ability to fight infection (including HPV infection) and increases the likelihood that precancerous cells will progress to cancer.
Sexual activity that increases the risk for infection with HPV and HIV and for cervical cancer includes the following:
- Having multiple sexual partners or having sex with a promiscuous partner
- History of sexually transmitted disease (STD)
- Sexual intercourse at a young age
In June of 2006, the Food and Drug Administration (FDA) approved a cervical cancer vaccine for girls and women between the ages of 9 and 26. This vaccine (Gardasil) has been shown to protect against the human papillomavirus (HPV).
Women who smoke cigarettes are twice as likely to develop cervical cancer. Chemicals in cigarette smoke may increase the risk by damaging cervical cells.
Other risk factors include age (the condition is rare in women younger than age 15) and race (invasive cancer rates are higher in African Americans, Hispanics, and Native Americans).
Regular screening with a Pap smear effectively lowers the risk for developing invasive cervical cancer by detecting precancerous changes in cervical cells. Women who do not receive regular Pap smears have a higher risk for the condition.
Signs And Symptoms Of Cervical Cancer
As a cancer of the cervix grows and invades the surrounding tissues it may form a tumour or lump on the cervix slide photograph. Most commonly the growth causes ulceration, which means breaking down of the epithelium and deeper tissues. As the tumour grows, the ulcer enlarges and grows away from its original site, leaving dead tissue at that site. This is known as necrotic tissue and often becomes infected.
Early symptoms of a cervical cancer are abnormal bleeding and a watery or mucous discharge. The bleeding may occur between periods or after intercourse. If there is secondary infection of the cancerous area then the discharge usually becomes thick and offensive.
If any of these symptoms occur then the cervix should be visualized with a speculum (as in a smear test) to exclude a tumour or ulcer. It should be emphasised that abnormal bleeding and vaginal discharge are extremely common symptoms and cervical cancer is a rare cause of these symptoms.
Cervical cancer is diagnosed by examination of a sample of the tumour (a biopsy) by a histopatholgist. The biopsy may be taken in the clinic by the examining gynaecologist or it may be taken as part of an examination under anaesthetic when the stage of the disease is determined.
What You Should Know
Any diagnosis of cancer causes great fear and anxiety, particularly when cervical cancer is diagnosed in a young woman where loss of fertility may be a major issue. It should be emphasised at the outset that cure rates for early stage cervical cancer are extremely high and that treatment is very effective in most cases.
After a diagnosis of cervical cancer, every woman should be referred to a specialist gynaecological cancer centre. Every region in the UK is now organized into cancer networks, each having a cancer centre or centres. These are hospitals where there are specialist teams with particular expertise in management of gynaecological cancer.
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