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Understanding Cervical Cancer

Cervical cancer can often be found early, and sometimes even prevented, by having regular screening tests. If detected early, cervical cancer is one of the most successfully treatable cancers.

Symptoms of Cervical Cancer

Cervical cancer often has no symptoms in the early stages. Symptoms may not appear until the cancer is advanced.

The most common symptom is bleeding from the vagina between periods, after sex, douching, a pelvic exam, and after menopause. Menstruation may also be heavy or last a long time, and there may be an unusual discharge from the vagina.

Later stages of cancer may cause:

  • Pain in the pelvis, belly or back
  • Problems passing urine or stool
  • Loss of hunger and weight
  • Being very tired
  • Swelling in the legs

Risk Factors for Cervical Cancer

Cervical cancer is more common in certain places. This includes developing countries and the southern U.S. Women who are impoverished also have a higher risk of cervical cancer because they may lack access to screening and treatment.

Other things that raise the risk for cervical cancer are:

  • Human Papillomavirus Infection - Human papillomavirus (HPV) is the biggest risk factor. HPV is passed through sexual contact. The viruses cause warts on the genitals and anus of males and females. Other types of HPV are linked with cancers of the vulva, vagina, penis, anus, and the back of the throat. Most HPV goes away on its own. However, lasting HPV infections can affect the cells of the cervix.
  • Abnormal Cervical Cells - Dysplasia is an abnormal change in cells. Cervical intraepithelial neoplasia (CIN) is abnormal change in cervical cells. CIN does not cause symptoms. It is diagnosed during Pap tests or biopsies. CIN raises the risk of cervical cancer. The main cause of CIN is a lasting HPV infection. CIN usually goes away on its own. If it does not, it may be surgically removed. A Pap test is an effective way to detect abnormal cell growth. Early detection is important. It can help stop dysplasia before it becomes cancer.
  • Sexual and Childbirth History - Women have a higher risk of cervical cancer if they have had multiple sex partners, have a sex partner who has had many sex partners, had sex before age 18, or have a history of sexually transmitted infections, such as chlamydia. The risk of cervical cancer is also higher in women who have had multiple children and were younger than 19 years old when they had their first child.
  • Smoking - Smoking affects every cell in the body. It raises the risk of irritation and changes in cells. These changes can lead to cervical and other cancers. The more cigarettes smoked and the number of years as a smoker raise this risk.
  • Weakened Immune System - The risk of cervical cancer is higher in people with a weak immune system. The immune system can be weakened by certain conditions or medicines. Examples are HIV or taking drugs that suppress the immune system. This can make infections more likely. It can also make it hard to fight off infections. In this case, a woman may be more likely to get an HPV infection. The infection may last and raise the risk of cervical cancer.
  • Family History - Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of developing the disease are higher than if no one in the family had it. Research suggests that some rare instances of this familial tendency are caused by an inherited condition that makes some women less able to fight off HPV infection than others.

Reducing Your Risk

Some steps to reduce the risk of cervical cancer are:

  • Vaccination - The U.S. Food and Drug Administration recently approved the use of Gardasil 9 for males and females ages 9 to 45. If you're age 27 to 45, discuss with your doctor whether he or she recommends that you get the HPV vaccine.
  • Practicing Safe Sex - HPV is passed through sexual contact. It is the main risk for cervical cancer. Women and men can reduce their risk of HPV and everyone can help reduce cervical cancer in women by:
    • Limiting sexual activity to one faithful partner
    • Using latex condoms correctly and consistently
    • Having regular checkups for sexually transmitted infections (STIs)
    • Seeking prompt treatment for any symptoms of an STI
  • Quitting Smoking - Smoking increases the risk of getting cervical cancer. The sooner smoking is stopped, the sooner the body can start to heal.
  • Eat a Healthful Diet - Eating a balanced diet helps reduce the risk of cervical and other cancers. This includes eating plenty of fruits and vegetables.
  • Manage Abnormal Cervical Cells - Abnormal cervical cells may appear years before cervical cancer. Regular Pap tests can help to detect them. Early detection offers the best chance for a cure.

Screening for Cervical Cancer

The purpose of screening is early diagnosis and treatment. Screening tests are given to people without symptoms, but who may be at high risk for certain diseases or conditions.

Screening tests to help detect cervical cancer include:

  • Pap test - A sample of cells in and around the cervix are taken and tested. The samples are checked for abnormal growth or cancer.
  • HPV test - The same sample of cells can be used to detect HPV infection.
  • Pelvic exam - The vagina, cervix, uterus, fallopian tubes, and ovaries are checked. This is done by hand.

Screening guidelines vary among medical groups. Screening also depends on a person's health. In general, for healthy women (without prior CIN 2 or higher) begin PAP tests at age 21 to 25 years. Women age 25 to 65 years old should have a Pap AND HPV test every five years. They may continue with Pap tests every three years, if desired. Women aged 65 years and older should stop having Pap and HPV tests if tests have been normal for the past 10 years.

Pap tests may be recommended more often for those with:

  • Abnormal results
  • A weak immune system from a health condition (such as HIV) or medicine
  • Exposure to diethylstilbestrol (DES) while in the womb
  • History of cervical dysplasia or cervical cancer