Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.
Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears.
Cervical cancers start in the cells on the surface of the cervix. There are two types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells.
Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for these changes to turn into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears or they have not followed up on abnormal Pap smear results.
Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that is spread through sexual intercourse. There are many different types (also called strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Yet others do not cause any problems at all.
A woman's sexual habits and patterns can increase her risk of developing cervical cancer. Risky sexual practices include:
Risk factors for cervical cancer include:
Most of the time, early cervical cancer has no symptoms. Symptoms that may occur include:
Cervical cancer may spread to the bladder, intestines, lungs, and liver. Often there are no problems until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include:
Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions.
If cervical cancer is diagnosed, the health care provider will order more tests. These help determine how far the cancer has spread. This is called staging. Tests may include:
Treatment of cervical cancer depends on:
Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. There are various surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future.
Types of surgery for early cervical cancer include:
A hysterectomy (surgery to remove the uterus but not the ovaries) is not often done for cervical cancer that has not spread. It may be done in women who have repeated LEEP procedures.
Treatment for more advanced cervical cancer may include:
Radiation may be used to treat cancer that has spread beyond the cervix or cancer that has returned.
Chemotherapy uses drugs to kill cancer. Some of the drugs used for cervical cancer chemotherapy include 5-FU, cisplatin, carboplatin, ifosfamide, paclitaxel, and cyclophosphamide. Sometimes radiation and chemotherapy are used before or after surgery.
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
How well the patient does depends on many things, including:
Precancerous conditions can be completely cured when followed up and treated properly. Most women are alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area. The 5-year survival rate falls as the cancer spreads outside the walls of the cervix into other areas.
Call your health care provider if you:
Cervical cancer can be prevented by doing the following:
Cancer - cervix
Jhingran A, Russell AH, Seiden MV et al. Cancers of the cervix, vulva, and vagina. In: Abeloff MD, Armitage JO, Niederhuber JE, et al. eds. Abeloff’s Clinical Oncology.4thed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2008:chap 91.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Cervical cancer. Version 2.2013. Available at http://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf. Accessed November 16, 2012.
Noller KL. Intraepithelial neoplasia of the lower genital tract (cervix, vulva): Etiology, screening, diagnostic techniques, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 28.
Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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