Cervical cancer is a disease in which malignant (cancer) cells form in the tissues of the cervix.
The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal).
Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which cells that are not normal begin to appear in the cervical tissue. Later, cancer cells start to grow and spread more deeply into the cervix and to surrounding areas.
Cervical cancer in children is rare. For more information, see the PDQ summary on Unusual Cancers of Childhood.
Human papillomavirus (HPV) infection is the major risk factor for development of cervical cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor.
Infection of the cervix with human papillomavirus (HPV) is the most common cause of cervical cancer. Not all women with HPV infection, however, will develop cervical cancer. Women who do not regularly have a Pap smear to detect HPV or abnormal cells in the cervix are at increased risk of cervical cancer.
Other possible risk factors include the following:
* Giving birth to many children.
* Having many sexual partners.
* Having first sexual intercourse at a young age.
* Smoking cigarettes.
* Oral contraceptive use ("the Pill").
* Weakened immune system.
There are usually no noticeable signs of early cervical cancer but it can be detected early with yearly check-ups.
Early cervical cancer may not cause noticeable signs or symptoms. Women should have yearly check-ups, including a Pap smear to check for abnormal cells in the cervix. The prognosis (chance of recovery) is better when the cancer is found early.
Possible signs of cervical cancer include vaginal bleeding and pelvic pain.
These and other symptoms may be caused by cervical cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
* Vaginal bleeding.
* Unusual vaginal discharge.
* Pelvic pain.
* Pain during sexual intercourse.
Tests that examine the cervix are used to detect (find) and diagnose cervical cancer.
The following procedures may be used:
* Pap smear: A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap test.
Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.
* Endocervical curettage: A procedure to collect cells or tissue from the cervical canal using a curette (spoon-shaped instrument). Tissue samples may be taken and checked under a microscope for signs of cancer. This procedure is sometimes done at the same time as a colposcopy.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) depends on the following:
* The patient's age and general health.
* Whether or not the patient has a certain type of human papillomavirus.
* The stage of the cancer (whether it affects part of the cervix, involves the whole cervix, or has spread to the lymph nodes or other places in the body).
* The type of cervical cancer.
* The size of the tumor.
Treatment options depend on the following:
* The stage of the cancer.
* The size of the tumor.
* The patient's desire to have children.
* The patient’s age.
Treatment of cervical cancer during pregnancy depends on the stage of the cancer and the stage of the pregnancy. For cervical cancer found early or for cancer found during the last trimester of pregnancy, treatment may be delayed until after the baby is born.