The cervix, or cervix (from Latin, neck, cervix), is an organ belonging to the female reproductive system. It corresponds to the lower part of the uterus and connects the upper part of the uterus to the vagina.

Location. The cervix is ​​the lower, narrow part of the uterus, located at the pelvis, the front of the rectum, and the back of the bladder. It connects the upper part of the uterus, the body, to the vagina.

Structure. With a length of 3 to 4 cm, the cervix consists of two parts (1):

• The ecocervix, which is the outer part of the cervix and is located in the upper part of the vagina.
• The endocervix, which corresponds to the internal part of the cervix and constitutes the endocervical canal. This canal continues to the isthmus, the point of separation between the cervix and the body of the uterus.

A passage zone exists between these two parts, called the junction zone or squamocolumnar junction.

Manufacture of mucus. In the endocervix, columnar cells, which are also glandular, produce and release mucus. During the menstrual cycle as well as during pregnancy, this mucus remains thick to create a barrier against semen and certain bacteria. Conversely, during ovulation, the mucus is thinner to allow sperm to pass.

Menstrual cycle. It constitutes the set of modifications of the female genital apparatus in order to be able to receive a fertilized egg. In the absence of fertilization, the endometrium, the lining of the uterine body, is destroyed and is evacuated through the cervix and then through the vagina. This phenomenon corresponds to menstrual periods.

Delivery. The cervix dilates during childbirth so that the baby can pass through.

Cervical dysplasia. Dysplasias are precancerous lesions. They most often develop at the junction area. Subsequently, they widen on both sides at the level of the ectocervix and endocervix.

Human papillomavirus. Human papillomavirus (HPV) is a sexually transmitted virus that exists in different forms. Some can cause benign lesions in the cervix. Others contribute to the development of precancerous lesions, known as the potentially oncogenic or “high risk” human papillomavirus (3).

Cervical cancer. Cervical cancer can appear when precancerous lesions develop into cancer cells.

Surgical treatment. Depending on the pathology and its progress, a surgical intervention may be performed such as the removal of part of the uterus (conization).

Chemotherapy, radiotherapy, targeted therapy. Cancer treatment can take the form of chemotherapy, radiotherapy or even targeted treatment.

Physical examination. The onset of pain begins with a clinical examination to assess the characteristics of the pain and the accompanying symptoms.

Colposcopy. This examination allows observation of the walls of the cervix.4

Biopsy. It consists of a tissue sample and is performed under colposcopy.

Pap smear. It consists of taking cells from the upper level of the vagina, ectocervix and endocervix.

HPV screening test. This test is performed to screen for human papillomavirus.

Since 2006, a vaccine has been available for the prevention of infections due to human papillomavirus. This medical progress was made possible thanks to the work of the virologist Harald zur Hausen, Nobel Prize winner for medicine in 2008 (5). After more than 10 years of research, he has succeeded in demonstrating the relationship between infections caused by a human papillomavirus and the occurrence of cancer.