Cervical Cancer – Causes, Symptoms and Treatment
Cervical cancer is a malignant tumor of the cervix uteri. It is one of the most common cancers in women worldwide and is largely preventable through early detection and HPV vaccination.
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Cervical cancer is a malignant tumor of the cervix uteri. It is one of the most common cancers in women worldwide and is largely preventable through early detection and HPV vaccination.
What is Cervical Cancer?
Cervical cancer is a malignant tumor that originates in the cells of the cervix uteri, the lower part of the uterus connecting to the vagina. It is one of the most common cancers affecting women globally, with approximately 660,000 new cases diagnosed each year worldwide. Thanks to modern screening programs and vaccination against human papillomavirus (HPV), cervical cancer is largely preventable.
Causes and Risk Factors
The primary cause of cervical cancer is a persistent infection with high-risk human papillomavirus (HPV), particularly subtypes HPV 16 and HPV 18, which together account for approximately 70% of all cervical cancer cases. HPV is transmitted through sexual contact. However, most HPV infections are cleared naturally by the immune system and do not lead to cancer.
Additional risk factors include:
- Early onset of sexual activity
- Multiple sexual partners
- Smoking
- Weakened immune system (e.g., due to HIV infection)
- Long-term use of oral contraceptives
- Lack of participation in cervical screening programs
Symptoms
In its early stages, cervical cancer often causes no noticeable symptoms. As the disease progresses, the following symptoms may occur:
- Abnormal vaginal bleeding (e.g., after sexual intercourse, between periods, or after menopause)
- Unusual vaginal discharge with abnormal odor or color
- Pelvic pain or discomfort
- Pain during sexual intercourse
- In advanced stages: back or leg pain, leg swelling
Diagnosis
The most important screening tool is the Pap smear (Papanicolaou test), which involves collecting cells from the cervix for cytological examination. In many countries, regular Pap smears are recommended from the age of 21 or the onset of sexual activity. HPV testing is often used alongside or in place of the Pap smear, depending on national guidelines.
If abnormal results are found, further investigations may include:
- Colposcopy: A detailed visual examination of the cervix using a magnifying instrument
- Biopsy: Removal of a small tissue sample for histological analysis
- Imaging: MRI, CT scan, or ultrasound to assess tumor extent and spread
Staging
Cervical cancer is staged according to the FIGO classification system (Stages I to IV). Stage I is confined to the cervix, while Stage IV indicates distant metastases.
Treatment
Treatment depends on the stage of the disease, the age of the patient, and whether the patient wishes to preserve fertility.
Surgery
For early-stage cervical cancer, surgical intervention is the primary treatment. Options include:
- Conization (cone biopsy): Removal of a cone-shaped section of cervical tissue (used for precancerous lesions or very early-stage cancers)
- Radical hysterectomy: Complete removal of the uterus, surrounding tissues, and lymph nodes
- Trachelectomy: Removal of the cervix while preserving the uterus (fertility-sparing option for eligible patients)
Radiation and Chemotherapy
For locally advanced cervical cancer, a combination of radiation therapy and chemotherapy (concurrent chemoradiotherapy) is the standard of care. Cisplatin is the most commonly used chemotherapy agent in this context and acts as a radiosensitizer.
Immunotherapy
For recurrent or metastatic cervical cancer, immune checkpoint inhibitors such as pembrolizumab have been approved and are increasingly used, either alone or in combination with chemotherapy, offering new treatment options for advanced disease.
Prevention
The most effective preventive measure is HPV vaccination, which is recommended for girls and boys before the onset of sexual activity. The vaccines protect against the most common cancer-causing HPV strains. Regular cervical screening (Pap smear and HPV testing) remains essential for early detection and treatment of precancerous changes before they develop into cancer.
References
- World Health Organization (WHO): Cervical Cancer Fact Sheet. WHO Global Cancer Observatory, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
- Bray F. et al.: Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide. CA: A Cancer Journal for Clinicians, 2024.
- National Cancer Institute (NCI): Cervical Cancer Treatment (PDQ) – Health Professional Version. U.S. National Institutes of Health, 2023. Available at: https://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq
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Related search terms: Cervical Cancer + Cervical Carcinoma + Cancer of the Cervix