What is cervical cancer?

Cervical cancer, also known as cervix cancer, is the fourth most common cancer type in women around the world after breast cancer, colon cancer and lung cancer.
For the case of Turkey, it’s amongst the 10 most common cancer types. The incidence of cervical cancer is 4,3 in 100,000.

The month of January is regarded as Cervical Cancer Awareness Month. It is important to raise awareness and be educated about the risk factors, symptoms, and treatment options for cervical cancer. In this article, we will provide detailed information on different aspects of cervical cancer and what you can do to protect yourself and others.

What is cervical cancer?

Cervical cancer is a type of cancer that affects the cervix, the lower part of the uterus that connects to the vagina. The cervix is responsible for regulating the passage of menstrual blood and sperm into the uterus. The cancer usually starts in the cells that line the cervix and can then spread to other parts of the body if left untreated.

Human papillomavirus (HPV) is the main cause of cervical cancer. However, there are other known risk factors that can increase a woman’s chances of developing cervical cancer. Some of these include:

• Smoking: Smoking is a known risk factor for cervical cancer. Women who smoke are two to three times more likely to develop cervical cancer than non-smokers. The chemicals in tobacco smoke can damage the DNA in cervical cells, making them more likely to become cancerous.
• Weak immune system: Women who have HIV or other conditions that weaken the immune system are at a higher risk of developing cervical cancer. The weakened immune system may not be able to fight off the HPV infection, increasing the risk of cervical cancer.
• Long-term use of oral contraceptives: Women who have taken birth control pills for a long time may have a slightly increased risk of cervical cancer. The risk of cervical cancer goes back to normal after stopping the use of oral contraceptives.
• Family history: Women who have a family history of cervical cancer may have an increased risk. If a woman’s mother or sister has had cervical cancer, her risk of developing cervical cancer is higher.
• Poor diet and nutrition: Poor diet and nutrition may also increase the risk of cervical cancer. Eating a diet low in fruits and vegetables and high in fat may increase the risk of cervical cancer.

Now, let’s get back to the main cause of cervical cancer. The human papillomavirus (HPV) is a sexually transmitted infection (STI) that can be contracted through skin-to-skin contact during sexual activity. This means that the virus can be spread through vaginal, anal, and oral sex, as well as through other intimate physical contact. It is one of the most common STIs and it is estimated that nearly 80% of sexually active people will contract HPV at some point in their lives. While over 150 types of HPV have been identified, only some are high-risk HPV types, known to cause health problems such as genital warts and cancers. n women, HPV 16 and HPV 18 are the two highest risk types, known to cause close to 70% of cervical cancer cases.

It’s important to note that not most women who have these risk factors do not develop cervical cancer. And having one or more risk factors does not mean that a woman will definitely develop cervical cancer, it means that her risk is higher. Regular cervical cancer screenings and the HPV vaccine can help prevent cervical cancer or detect it early, when it is most treatable.

Symptoms:

In its early stages, cervical cancer may not cause any symptoms. As the cancer progresses, symptoms may include:

-Abnormal vaginal bleeding: This can occur between menstrual periods, after sexual intercourse, or after menopause. Although the bleeding can sometimes be heavy, it is usually in the form of “spotting”. It can be more evident after a sexual intercourse. Vaginal discharge with foul odor or blood in urine or stool can be seen in advanced stages of the disease.

-Pain during intercourse: Pain during intercourse is a common symptom of cervical cancer.

-Pelvic pain: Some women may experience pelvic pain, which is a dull ache in the lower abdomen or pelvis.

Screening and diagnosis:

• Regular cervical cancer screenings, such as a PAP Smear test or HPV test, can help detect cervical cancer in its early stages when it is most treatable. A Pap test is a procedure in which a sample of cells is taken from the cervix and examined under a microscope for abnormalities. An HPV test looks for the presence of the virus that causes cervical cancer. If cervical cancer is suspected, a biopsy of the cervix may be performed to confirm the diagnosis.

Developmental Course:

Intact cervix starts manifesting changes related to infection 3 to 8 months of inoculation period after the cervix is exposed to HPV.

• Such changes may spontaneously disappear or convert into low-grade cervical lesion, precancerous cells.
• Not all precencerous cells turn into cancer. Low-grade cervical lesions regress and disappear in 60% of patients in 2 to 3 years, but 15% of cases can progress into high-grade cervical lesion in 3 to 4 years based on combined effects of other carcinogens.
• 30 to 70% of patients with high-grade cervical lesion can develop cancer in 10 years, if left untreated.

Treatment options:

• Treatment for cervical cancer may include surgery, radiation therapy, and chemotherapy. The specific treatment plan will depend on the stage of the cancer and the patient’s overall health. Surgery is the most common treatment for cervical cancer, which can include removal of the cervix, uterus or both. Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Chemotherapy uses drugs to kill cancer cells and shrink tumors.

 Prevention:

• The most effective way to prevent cervical cancer is to get regular cervical cancer screenings and to receive the HPV vaccine. In general, doctors recommend beginning Pap testing at age 21. It is generally recommended to repeat Pap testing every three years for women ages 21 to 65. If you have certain risk factors, your doctor may recommend more-frequent Pap smears, regardless of your age. These risk factors include:
• A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
• Exposure to diethylstilbestrol (DES) before birth
• HIV infection
• Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use
• A history of smoking
• The HPV vaccine can protect against the types of HPV that cause most cases of cervical cancer. It is recommended that all children aged 11 or 12 years should get the HPV vaccine as a routine part of their immunization schedule. The vaccine is given in a series of two or three shots, depending on the age of the individual. For teenagers and young adults who did not receive the HPV vaccine when they were younger, the vaccine is recommended up to age 26 for females, and up to age 21 for males.
• It is important to practice safe sex, such as using condoms, to reduce the risk of contracting HPV and other STIs. It is important to note that even if someone is already sexually active, they can still benefit from getting the HPV vaccine because they may not have been exposed to all the types of HPV covered by the vaccine. It’s always a good idea to consult with a healthcare professional to discuss the HPV vaccine and if it is right for you or your loved ones. They can provide you with more information and answer any questions you may have about the vaccine and the vaccination schedule.
• It is important to note that it is less likely, but still possible, to contract HPV through non-sexual means such as skin-to-skin contact. It is unlikely to contract HPV from public toilets and pools because the virus does not survive well on surfaces and objects like toilets, seats, or water. However, it is always important to practice good hygiene, such as washing your hands and not sharing personal items like towels, to reduce the risk of contracting other infections.

By raising awareness about the risk factors, symptoms, and treatment options for cervical cancer, we can help women take steps to protect themselves. Remember to schedule regular cervical cancer screenings and consider getting the HPV vaccine. Early detection and prevention are key in the fight against cervical cancer.