What is Cervical Cancer?As the name suggests, cervical cancer affects your cervix. For people who may not know of the cervix, it is part of your reproductive organ that connects your uterus (womb) to the vagina. When someone is pregnant and getting close to labor, the cervix can indicate to your healthcare provider when you are likely to give birth. Also, it serves as a passage for sperm cells to get to the eggs in the uterus for fertilization, and it allows menstrual fluid to flow from the uterus to your vagina. Cervical cancer is a condition that turns the normal cells of your cervix cancerous. If you have cancer in your cervix, the normal cells have become problematic, continuously growing and dividing and destroying your cervical tissue. In worst-case scenarios, it spreads to other distant body parts, causing even more harm. Cervical cancer is ranked as the 4th most common cancer affecting people with cervices. In fact, current statistics for 2022 from the American Cancer Society estimate 4280 deaths due to cervical cancer and 19,100 new cases to be diagnosed in the USA. Cervical cancer is most commonly diagnosed between 35 and 44 years old, with 50 being the average age of diagnosis.
What Causes Cervical Cancer?According to CDC, human papillomavirus HPV is the most common cause of cervical cancers. Over 95% of cervical cancer has been attributed to HPV. HPV is a sexually transmitted infection. 80% of people who are sexually active, have contracted at least one type of genital HPV at some point in their lives. However, not all species of HPV can cause cancer. There are over 100 different strains of HPV. “HPV is a group of viruses. But, there are many subtypes, and the most concern is the one causing cervical cancer, subtypes 16 and 18”says Dr. Daniel Kimani. Some are low-risk HPV, and others high-risk HPV. Low-risk HPVcan cause warts around the male and female genitals; these strains are not cancer-prone. In contrast, high-risk HPV can cause cervical, penile, anal, mouth, and throat cancers. You can contract HPV through skin-to-skin contact, anal, or vaginal sex.
What are the Risk Factors for Cervical Cancer?With risk factors, your chances of getting a certain infection are increased. Some risk factors of cervical cancer are:
- HPV: Human papillomavirus is the most well-known cause of cervical cancer, and if you're infected with HPV, it increases your chances of cervical cancer.
- Sexual history: HPV is a sexually transmitted infection, so anyone sexually active is susceptible and could contract the virus anytime. If you had an early start to sex, or if you have multiple sexual partners there is a higher probability of contracting HPV. Furthermore, infections such as chlamydia are associated with cervical cancer. A study published in the American medical association journal found that people who have chlamydia infection are 2.5 times more likely to develop cervical cancer,
- Pregnancy and childbirth: Research suggests an existing relationship between childbirth and the development of cervical cancer. The probability is 2.6 times higher with 3-4 births, and about 3.8 times more risk with about 7 births. Although the underlying mechanism is not well understood, some studies speculate that increased risk is due to the changes in the cells of your cervix caused by the trauma of childbirth and hormonal changes experienced in pregnancy.
- Smoking: When you smoke, you inhale harmful substances that cause cellular changes in your cervix that can degenerate into cancer. The American cancer society, says the possibility of developing cervical cancer is twice as much in people who smoke.
- Weak Immune System: When your immune system has been weakened or suppressed, it is harder to fight infections. Some people contract HPV at some point in their lives, and the virus clears on its own without worsening to cervical cancer. While some others whose immunity has been suppressed by infections like HIV, it is tough to fight and clear the virus leading to a persistent case of HPV, a building block for cervical cancer.
- Genetics: If your first-degree relative (parents, siblings and children) had cervical cancer, you will need more intensive follow-up than someone with no family history of cervical cancer. On the contrary, you could have inherited some specific genes that may predispose you to develop cervical cancer.
What are the Signs of Cervical Cancer?Early stages of cervical cancer do not present with noticeable signs. “Early cases are asymptomatic. That’s why it’s so crucial to conduct early screening to avert progression of this condition” says Dr. Daniel Kimani. We'll talk about screening later in the article; let's start with the signs which are as follows:
- Pain during sexual intercourse
- Abnormal vaginal bleeding
- Persistent vaginal discharge
- Heavy and smelly discharge
- Pelvic pain
- Bleeding after menopause
- Unusual menstrual bleeding
How is Cervical Cancer Diagnosed?When an individual with a cervix contacts HPV, it goes through different stages of dysplasia before it becomes an invasive cancer. The good news is that this progression does not happen overnight; it can take several years (15-20 in individuals with a healthy immune system and 5-10 when your immunity is weak). At the point of dysplasia, a pap smear will detect the abnormal cells in your cervix, and your doctor can commence treatments to arrest the growth of the infection so that cervical cancer can be avoided. Without a pap smear, you wouldn't know you have dysplasia because it has no visible signs. As a result, the diagnostic effort aims to detect the infection as early as possible using Pap smear and HPV DNA testing. A Pap smear detects abnormal cells or pre-cancer changes in your cervix, while HPV testing detects presence of high-risk HPV that can cause cervical cancer. The following organizations; American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology have established the following cervical cancer screening guidelines for individuals with a cervix:
- If you are less than 21 years, you are not eligible for screening tests.
- If you are between 21 and 29 years, only cytology (pap smear test) is recommended.
- If you are between 30 and 65 years, pap smears are recommended every three years, or pap smear and HPV testing every five years.
- If you had a hysterectomy and have no history of cervical cancer in 20 years, there's no need for a screening test.
- If you are above 65 years, no screening is recommended if all previous screening results have been negative.