Cervical cancer develops in the lining of the cervix which is in the lower part of the uterus (womb). The cervix unites the body of the uterus to the vagina. Cervical cancer is the 2nd most common cancer of the female reproductive tract and usually affects women in their 40s to 55 years of age.

Cervical cancers are not known to form suddenly but over time. Normal cervical cells gradually develop into precancerous cells which in turn may develop into cancerous cells. It is important for women to get routine pap smears and check-ups with their physician. If these precancerous cells are caught early, almost all cancers can be prevented and/or treated.

Types of cervical cancers

There are 3 main types of cervical cancers:

1.         Squamous cell carcinoma typically presents as an ulcerated lesion. It is felt that squamous cancers develop from preexisting dysplastic lesions.

2.         Adenocarcinoma of the cervix accounts for 5 to 20% of cervical cancers and usually presents as an enlarged barrel-shaped cervix. It has been observed that adenocarcinomas are becoming more common in women who were born in the last 20 to 30 years.

3.         Adenosquamous carcinomas are cervical cancers which have both features of squamous cell carcinomas and adenocarcinomas and are less common.

Symptoms

Early cervical cancer is sometimes painless and may not produce symptoms. The first sign may be an abnormal pap smear. Other symptoms may include:

•          Abnormal vaginal bleeding or spotting

•          Bleeding after intercourse

•          Vaginal discharge

•          Low back pain

•          Pelvic pain

•          Dyspareunia or painful sexual intercourse

•          Dysuria or painful urination

Etiology

The cause of cervical cancer is unknown however it is felt there are many risk factors.

Human papillomavirus virus (HPV) is the most important risk factor to speak of. Normally, a female will develop this virus before she develops cervical cancer. There are over a 100 different types of papillomaviruses. Some of these viruses may cause warts while others may cause cervical cancer. Many times a woman with a good immune system is successful in fighting off the virus and does not develop cervical cancer.

A common vaginal infection known as Chlamydia puts a woman at greater risk for cervical cancer. Long term infection without treatment may also cause infertility.

Certain dietary patterns such as low intake of fruits and vegetables may also be a risk factor for cervical cancer. Research shows that overweight women are more likely to develop cervical cancer along with other types of cancers such as breast cancer.

Women who have had many full-term pregnancies also have an increased risk of developing cervical cancer.

There is evidence that long term use of oral contraceptive for 5 or more years may increase the chances of cervical cancer.

Women who smoke are about twice as likely as nonsmokers to develop many different types of cancers. This is especially true for cervical cancers. Tobacco by-products have been found in the cervical mucus.

Cervical carcinoma is more common in women of low socioeconomic status.

Other risk factors include history of multiple sexual partners and intercourse starting at a young age. Cervical cancer seems to be rare in sexually inactive women.

Cervical Cancer Glossary

•          Benign:not malignant; not recurrent; not cancerous.

•          Biopsy: the removal and examination of a small piece of tissue from the living body to determine if cancer cells are present.

•          Chemotherapy: a treatment for disease by using chemical agents.

•          Chlamydia: a bacterial infection spread by sexual contact which can infect the female reproductive tract.

•          Dysplasia: abnormal cells found on a pap smear report which shows alteration in size, shape, and organization of adult cervical cells.

•          Dyspareunia: difficult or painful intercourse.

•          Dysuria: painful or difficult urination.

•          Precancerous cells: cells which tend to become cancerous cells; a pathologic process that eventually tends to become malignant.

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