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At first, cervical cancer may not cause signs and symptoms. Advanced cervical cancer can cause bleeding or vaginal discharge that should not come out. Cervical cancer is caused by the human papillomavirus (HPV). Read about cervical cancer symptoms, types, diagnosis and treatment.
Cervical cancer – characteristics
Cervical cancer grows in the cells that line the cervix, the cylindrical connective tissue between the vagina and the uterus. The cervix consists of two parts: the vaginal, which is at the top of the vagina and is covered with squamous cells, and the abdominal, which is at the bottom of the uterus and is covered with glandular cells. The combination of the two cell types is known as the transformation zone where most cervical cancers begin.
Most cervical cancers develop gradually after normal cells in the transformation zone undergo precancerous changes. However, not all pre-cancerous cells develop into cervical cancer. Moreover, when precancerous cells are detected and treated early, cervical cancer can often be prevented or treated.
Every year around the world, cervical cancer is diagnosed in about half a million women, including about 2,5 thousand women. Polish women. Of the cancers in women, 1 in 25 new cases are cancer of the cervix.
Cervical cancer is detected in Poland most often in women over 60 years of age – in 46 patients per 100. women. According to the data of the National Cancer Registry, in the years 1999-2016 in Poland the incidence of cervical cancer decreased by 26,5%, while the number of deaths from cervical cancer decreased by 15,5%.
Read: Vaginitis – causes, treatment
Cervical cancer – HPV
The human papillomavirus (HPV) causes approximately 91% of cervical cancer cases. There are over 100 different types of HPV, most of which are considered low-risk and do not cause cervical cancer. High-risk HPV types can cause cervical abnormalities or cancer. More than 70 percent of cervical cancer cases can be attributed to two types of the virus, HPV-16 and HPV-18, often referred to as high-risk HPV types.
In fact, by the age of 50, about 80% of women were infected with some type of HPV. Most women who become infected with HPV may not develop cervical cancer. In most women, HPV infection does not last long, 90% of HPV infections resolve on their own within 2 years. A small number of women do not clear HPV and are considered to have a “persistent infection”.
A woman with a persistent HPV infection is more likely to develop cervical abnormalities and cancer than a woman who resolves the infection on its own. Certain types of this virus are able to turn normal cervical cells into abnormal ones. In a small number of cases, and usually over a long period of time (from several years to tens of years), some of these abnormal cells can then develop into cervical cancer.
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Cervical cancer – types
The main types of cervical cancer are squamous cell carcinoma and adenocarcinoma. The majority (up to 9 in 10) of cervical cancers are squamous cell carcinomas. These tumors develop from cells on the outside of the cervix. Squamous cell carcinoma most often begins in the transformation zone (where the outer cervix meets the cervix).
Most of the other cervical cancers are adenocarcinomas. Adenocarcinomas are cancers that develop from glandular cells. Cervical adenocarcinoma develops from glandular cells in the cervical lining that produce mucus.
Less commonly, cervical cancer has features of both squamous cell carcinoma and adenocarcinoma. These are called glandular squamous carcinomas or mixed carcinomas.
While almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer can also develop in the cervix. The other types of melanoma, sarcoma and lymphoma are more common in other parts of the body.
At Medonet Market you can order a modern and accurate LBC liquid cytology with gynecological consultation.
Cervical cancer – risk factors
Anything that increases your risk of developing cancer is a risk factor. While risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors will never develop cancer, while others with no known risk factors do develop. Knowing your risk factors and talking about them with your healthcare provider can help you make more informed lifestyle and healthcare choices.
The following factors may increase your risk of developing cervical cancer.
Human papillomavirus (HPV) infection – HPV infection is the most important risk factor for cervical cancer. HPV is common. Most people contract HPV when they become sexually active. There are over 100 different types of HPV. Not all of them are related to cancer. The HPV types or strains most commonly associated with cervical cancer are HPV16 and HPV18. Beginning intercourse at a younger age or having multiple sexual partners puts a person at greater risk of contracting high-risk HPV types.
A lowered immune system – people with a lowered immune system have a higher risk of developing cervical cancer. A lowered immune system can be caused by immune suppression from corticosteroid medications, organ transplant, treatment for other types of cancer, or the human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS). When a person is infected with HIV, their immune system is less able to fight early cancer.
Genital herpes – women with genital herpes have a higher risk of developing cervical cancer.
Smoking tobacco – Women who smoke are approximately twice as likely to develop cervical cancer as women who do not smoke.
Age – people under the age of 20 rarely develop cervical cancer. The risk increases between teens and thirties. Women in this age group remain at risk and must undergo regular cervical screening, which includes a Pap smear and / or HPV test.
Socio-economic factors – Cervical cancer is more common in the groups of women who are less likely to have access to cervical cancer screening.
Oral contraceptives – Some research studies suggest that oral contraceptives may be associated with an increased risk of cervical cancer and may be associated with more risky sexual behavior. However, more research is needed to understand how oral contraceptive use is linked to the development of cervical cancer.
Exposure to diethylstilbestrol (DES) – women whose mothers received this medicine during pregnancy to prevent miscarriage have an increased risk of developing a rare cancer of the cervix or vagina. DES was administered for this purpose from around 1940 to 1970. Women exposed to DES should have an annual pelvic exam, which includes a cervical cytology test, as well as a 4-quadrant cytology test, in which cell samples are taken from all sides of the vagina to check for abnormal cells.
Various studies continue to examine what factors contribute to the development of cervical cancer. There is no proven way to completely prevent this disease, but you can reduce your risk of it occurring. Talk to your doctor / gynecologist if you have concerns about your personal risk of developing cervical cancer.
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Cervical cancer – symptoms
Many women with cervical cancer do not realize they have cancer because usually in the early stages of the disease, the cancer does not cause any symptoms. When symptoms appear, they can be easily confused with a urinary tract infection (UTI), for example.
In most cases, early cervical cancer is asymptomatic. Symptoms that may appear over time include:
- continuous discharge that may be pale, watery, pink, brown, bloody, or smelly
- abnormal vaginal bleeding between periods, after intercourse or after the menopause
- periods that become heavier and last longer than usual
- any bleeding after menopause.
Symptoms of advanced cervical cancer can include:
- loss of appetite
- weight loss
- tiredness,
- pelvic, back and / or leg pain
- single swollen leg,
- heavy bleeding and / or leakage of urine or faeces from the vagina
- bone fracture.
If you notice any of these symptoms, see your doctor for a checkup.
Back pain and discomfort in the back which can also lead to leg pain which may be caused by the pressure of a growing tumor or abnormal growth. In these cases, your doctor will likely be able to see the tumor through an imaging test such as an x-ray.
Swelling in the legs can occur if the tumor is putting pressure on the lymph nodes or glands that are part of the immune system, which can cause blood and fluid to build up in the legs.
Bowel and bladder symptoms, symptoms can include painful urination and / or bowel movements, as well as loss of bowel and bladder control.
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Cervical cancer – diagnosis
Pap smear, i.e. Cervical smear, Pap smear – also known as the Pap test – is used to diagnose cervical cancer. During a Pap smear, your doctor takes a sample of cells from your cervix with a small brush or cotton ball. The sample is then sent to a laboratory to be examined for any signs of cancer or a precancerous condition.
Physical examinations can also help detect abnormalities. The doctor may use a speculum to observe the vagina and inspect the ovaries and uterus by inserting two fingers while pressing down on the abdomen with the other hand.
If the Pap smear shows cellular changes, additional tests may be recommended. It could be:
- colposcopy – allows your doctor to look at your cervix through a speculum and then check for abnormal areas with a solution called acetic acid
- biopsy – allows you to take a small sample of tissue to check for abnormal cells in the lab.
If a patient is diagnosed with cervical cancer after a biopsy, doctors may order additional tests to determine the stage of the cancer. These studies may include computed tomography (CT), positron emission tomography (PET) scans, X-rays, magnetic resonance imaging (MRI), or a combination of these. Rectal or bladder examinations may also be performed.
Cervical cancer – treatment and testing
Depending on the severity of the disease, treatment includes surgery, radiotherapy, brachytherapy, and chemotherapy, as well as a combination of several treatments.
If the tumor is less than 4 cm, the uterus, some surrounding tissues and organs, and lymph nodes are most often removed. In the case of metastasis, treatment is based on chemotherapy and / or radiotherapy.
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For many years, preventive programs have been carried out so that as many women from the risk group as possible can have a cytology. The cervical cancer prevention program (cytology) is addressed to women aged 25-59:
- who have not had a Pap smear test in the last three years,
- with risk factors (HIV-infected, taking immunosuppressive drugs, infected with HPV – the high-risk type), who have not had a Pap smear test in the last 12 months.
Women who were treated for a malignant neoplasm of the cervix, after the end of the oncological inspection (the decision is made by the doctor in charge of cancer treatment), are re-included in the program.
Cervical cancer – prevention
Most cervical cancers form in the cells that line the cervix and gradually develop precancerous lesions which, if left undetected, turn into cancer.
Cervical cancer often goes unnoticed because it has minimal symptoms. This lack of detection causes an alarming number of women to lose the battle against cervical cancer every year, despite being a highly preventable and treatable disease.
Protect yourself from cervical cancer with these recommended prevention and screening practices.
- HPV vaccine: Most cervical cancers are caused by the human papillomavirus (HPV). Vaccines are now available to prevent infection with the most common HPV subtypes. The vaccine is given as three injections over a period of 6 months to girls and young women aged 9 to 26 years. Studies have shown that vaccines appear to prevent early stage cervical cancer and precancerous lesions.
- Regular Pap smears: This potentially life-saving screening test looks for precancerous lesions that can be treated before they develop into cervical cancer. Pap smears are good for detecting such changes, but should be performed regularly. Annual gynecological examinations should begin when the woman becomes sexually active or at the age of 20 for a sexually inactive woman. Pap smear tests should be started at the age of 21. If abnormal changes are found, colposcopy with biopsy should be performed. Colposcopy is a painless procedure in which the doctor uses an illuminated microscope to view the cervix.
- Safe sex: practicing safe sex (using condoms) also reduces the risk of contracting HPV and other sexually transmitted diseases. HPV infection causes genital warts. If a woman sees warts on her partner’s genitals, she should avoid intercourse with that person. To further reduce the risk of cervical cancer, women should limit the number of sexual partners and avoid partners who engage in high-risk sexual activities.