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Medicine LibreTexts

29.17C: Cervical Cancer

  • Page ID
    8392
  • Cervical cancer is a cancer that originates in the cervix of a female.

     

    LEARNING OBJECTIVES

     

    List causes and methods of prevention in cervical cancer

     

    KEY TAKEAWAYS

    Key Points

     

    • Human papillomavirus ( HPV ) is a major cause of cervical cancer.
    • Pap smears are used to identify precancerous tissue in the cervix.
    • Aside from HPV, smoking and STDs are other major risk factors for cervical cancer.
    • The early stages of cervical cancer may be completely asymptomatic, but symptoms of advanced stages may include loss of appetite, weight loss, fatigue, pain, swollen legs, and bleeding from the vagina.

     

    Key Terms

     

    • cervical cancer: A type of cancer of the cervix of the uterus which can afflict some female mammals including humans. The term usually does not refer to cancer of the neck or other parts of the anatomy which use the term cervix.
    • Pap smear: The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used to detect potentially pre-cancerous and cancerous processes in the endocervical canal (transformation zone) of the female reproductive system.
    • human papillomavirus: A virus that affects humans, sometimes causing cervical or other cancer; it is sometimes classified as a sexually transmitted disease.

    Cervical cancer is the term for a malignant neoplasm arising from cells originating in the cervix uteri. One of the most common symptoms of cervical cancer is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer has progressed to an advanced stage. Treatment usually consists of surgery (including local excision) in early stages, and chemotherapy and/or radiotherapy in more advanced stages of the disease.

    image

    Squamous carcinoma of the cervix: This large squamous carcinoma (bottom of picture) has obliterated the cervix and invaded the lower uterine segment. The uterus also has a round leiomyoma up higher.

    The cervix is the narrow portion of the uterus where it joins with the top of the vagina. Most cervical cancers are squamous cell carcinomas, arising in the squamous (flattened) epithelial cells that line the cervix. Adenocarcinoma, arising in glandular epithelial cells is the second most common type. Very rarely, cancer can arise in other types of cells in the cervix.

    Symptoms

    The early stages of cervical cancer may be completely asymptomatic. Vaginal bleeding, contact bleeding, or (rarely) a vaginal mass may indicate the presence of malignancy. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere.

    Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, swollen legs, heavy bleeding from the vagina, bone fractures, and/or (rarely) leakage of urine or feces from the vagina (rarely).

    Diagnosis

    Cancer screening using the Pap smear can identify precancerous and potentially precancerous changes in cervical cells and tissue. Treatment of high-grade changes can prevent the development of cancer in many victims. In developed countries, the widespread use of cervical screening programs has reduced the incidence of invasive cervical cancer by 50% or more. While the pap smear is an effective screening test, confirmation of the diagnosis of cervical cancer or pre-cancer requires a biopsy of the cervix.

    HPV

    Human papillomavirus (HPV) infection appears to be a necessary factor in the development of almost all cases (90+%) of cervical cancer. HPV vaccines effective against the two strains of this large family of viruses that currently cause approximately 70% of cases of cervical cancer have been licensed in the U.S., Canada, Australia, and the EU. Since the vaccines only cover some of the cancer causing (“high-risk”) types of HPV, women should seek regular Pap smear screening, even after vaccination.

    Infection with some types of human papilloma virus (HPV) is the greatest risk factor for cervical cancer, followed by smoking. Other risk factors include human immunodeficiency virus. Not all of the causes of cervical cancer are known, however, and several other contributing factors have been implicated.

     

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