Diseases & Conditions

 

Cervical Cancer

Diseases & Conditions

 

What is Cervical Cancer?

Cervical cancer is a form of cancer caused by the growth of malignant cells developing in the cervix. The cervix is the lower part of the uterus that connects to the vagina.1 It is possible for women of all ages to develop cervical cancer, although most cases affect women under 50.2

There are two types of cervical cancer:

  • Squamous cell carcinoma which is the most common type that begins in the squamous cells of the cervix
  • Adenocarcinoma are cancers that develop from mucus-producing gland cells of the cervical

Cervical cancer is the fourth most common cancer in women worldwide after breast, colorectal and lung cancers. Overall, 528,000 new cases of cervical cancer were reported in 2012 mostly in lower resource countries.3

In Saudi Arabia, cervical cancer is the twelfth most common cancer in women with a very low incidence accounting only for 2.4% of all new cases.4 This low prevalence of cervical cancer in the kingdom is probably due to environmental, cultural and genetic differences from the rest of the world.5

 

What are the causes and risk factors for cervical cancer?

It is not clear what causes cervical cancer but the major risk factor is infection with human papillomavirus (HPV). HPV infection is common and is transmitted via skin-to-skin contact and body fluids. HPVs are a group of more than 100 related viruses. About 40 types are sexually transmitted through genital contact. Other risk factors include: 6

  • Multiple sexual partners increases the risk of acquiring HPV infection
  • Starting sexual activity at young age also increases the risks of getting infected with HPV
  • Smoking has an effect on the immune system and hence can influence the likelihood of cervical cancer development
  • A weakened immune system (having HIV for example)
  • Being overweight or obese
  • Having relatives with cervical cancer history.7

 

 

What are the symptoms of cervical cancer?

At early stages, cervical cancer may not cause any signs or symptoms. At advanced stages, the symptoms of cervical cancer may include: 8

  • Abnormal bleeding (during sex or after menopause)
  • Unusual vaginal discharges containing blood
  • Pelvic pain
  • Blood in the urine
  • Bowel symptoms
  • Blood in the stool
  • Discomfort or pain during sex
  • Loss of appetite
  • Weight loss
  • Weakness and fatigue

 

How is cervical cancer diagnosed?

Early detection can prevent 75% of cervical cancer rates.9 Screening tests include:

  • Papanicolaou (Pap) smear test: In order to be diagnosed, women must undergo a test by cytology called the Pap smear. The Pap smear is a screening test performed using cells from the uterine cervix and is capable of detecting cervical cancer cells at early stage when treatment is more effective. The Pap test is recommended for women aged 21 to 65 years old.
  • HPV DNA test: This test checks for the genetic material of the human papillomavirus than can be done in women who have slightly abnormal Pap test results.

If screening tests revealed to be suspicious, a thorough examination of the cervix should be performed. These tests include: 10

  • Colposcopic examination: An instrument (colposcope) is used to check for abnormal cells
  • Biopsy: Cervical cells sample is taken from the cervix for laboratory testing. Many tests are used to perform a biopsy

 

 How is cervical cancer treated?

Cervical cancer can be effectively treated if detected and diagnosed early. Surgery is often the treatment of choice when the cancer is early diagnosed. On the other hand, a variety of treatments is available for patients with more advanced stages such as radiotherapy and chemotherapy.11

  • Surgery: Cervical surgery known as hysterectomy consists of removing the cancer in the cervix, uterus and sometimes a part of the vagina and lymph nodes are also removed with the cancer
  • Radiation therapy: Using X-ray beams to kill cancer cells, radiation therapy may be used before surgery with chemotherapy to limit the tumor or after surgery to kill any remaining cancer cells
  • Chemotherapy: Chemotherapy is the use of drugs that can kill cancer cells. These drugs can be taken orally or intravenously. They enter the bloodstream and reach most parts of the body, making this treatment useful for cancers that have spread to distant organs.

 

Can cervical cancer be prevented?

It has been shown that HPV vaccines can dramatically reduce the risk of cervical cancer. It protects against HPV-16 and HPV-18, which cause about 70% of cervical cancers worldwide. The vaccine is recommended for girls and women aged 13 to 26.

In addition, going for regular Pap smears test at least every 3 years and quitting smoking have been shown to prevent cervical cancers.12

New studies have shown that a diet containing fruits vegetables and vitamins plays a protective effect against HPV.13

 

 References:

  1. What is cervical cancer? (What is cervical cancer?) http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-what-is-cervical-cancer
  2. "CERVICAL CANCER." Cancerresearchuk. 1 Nov. 2014. Web. http://publications.cancerresearchuk.org/downloads/product/CS_KF_CERVIX.pdf (Accessed December 20, 2015)
  3. International Agency for Research on Cancer. "Latest world cancer statistics Global cancer burden rises to 14.1 million new cases in 2012: Marked increase in breast cancers must be addressed." World Health Organization 12 (2013).
  4. Alsbeih, Ghazi. "HPV infection in cervical and other cancers in Saudi Arabia: implication for prevention and vaccination." Frontiers in oncology 4 (2014).
  5. Alsbeih, Ghazi, et al. "HPV prevalence and genetic predisposition to cervical cancer in Saudi Arabia." Infect Agent Cancer 8.1 (2013): 15.
  6. Zarchi, Mojgan Karimi, et al. "Cervical cancer and HPV vaccines in developing countries." Asian Pacific J Cancer 10 (2009): 969-974.
  7. Magnusson, Patrik KE, Pär Sparén, and Ulf B. Gyllensten. "Genetic link to cervical tumours." Nature 400.6739 (1999): 29-30.
  8. Saonere, Jyotsna A. "Awareness screening programme reduces the risk of cervical cancer in women." African Journal of Pharmacy and Pharmacology 4.6 (2010): 314-23.
  9. Bukhari, Mulazim Hussain, et al. "Clinicopathological importance of Papanicolaou smears for the diagnosis of premalignant and malignant lesions of the cervix." Journal of cytology/Indian Academy of Cytologists 29.1 (2012): 20.
  10. Cervical cancer (Tests and diagnosis) http://www.mayoclinic.org/diseases-conditions/cervical-cancer/basics/tests-diagnosis/con-20030522 (Accessed December 20, 2015)
  11. Cervical, ovarian, and uterine cancers. by : Berria, Matthew, Ph.D., Magill’s Medical Guide (Online Edition), January, 2013
  12. Can cervical cancer be prevented? (Can cervical cancer be prevented?) http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-prevention
  13. García?Closas, Reina, et al. "The role of diet and nutrition in cervical carcinogenesis: a review of recent evidence." International journal of cancer 117.4 (2005): 629-637.