What is cervical cancer?

Cervical cancer is a form of cancer that develops in the cells of the cervix, which connects the uterus to the vagina. Most cervical cancers are caused by different forms of the human papillomavirus (HPV), a sexually transmitted infection. When the body comes in contact with HPV, the immune system usually stops the virus from causing harm. However, in a small number of people, the virus lives for years, contributing to the process by which some cervical cells develop into cancer cells.

Causes of Cervical Cancer

There can be genetic causes of cervical cancers. However, some of the other causes include:

Numerous sexual partners: The more sexual partners you have, the more likely you are to contract HPV.

Sexual activity at an early age: Having sex at a young age raises your risk of HPV. Other sexually transmitted diseases (STIs). Other STIs, such as chlamydia, gonorrhoea, syphilis, and HIV/AIDS, enhance your chances of contracting HPV.

A weak immune system: If another health issue impairs your immune system and you have HPV, you may be more likely to develop cervical cancer.

Smoking: Smoking can cause squamous cell cervical. It can increase the risk of cervical cancer.

Also Read: What Women Need to Know About Cervical Cancer

Different types of Cervical Cancer

There are mainly two types of cervical cancer. At times cervix cancer can involve both types of cells. Cancer in other cervix cells occurs very rarely.

Cervical is classified into two types:

Squamous cell carcinomas

Cervical cancer of this type originates in the thin, flat cells (squamous cells) that line the outer section of the cervix and project into the vagina. Squamous cell carcinomas account for the majority of cervical malignancies.

Adenocarcinoma

Cervical cancer of this type begins in the column-shaped glandular cells that line the cervical canal.

Symptoms of cervical cancer

In the case of cervix cancer, there are usually no symptoms in its early stages. The visible symptoms mostly begin after the cancer has progressed. The following are the signs and symptoms of advanced cervical cancer:

• Vaginal bleeding following intercourse, between periods, or during menopause
• Watery vaginal discharge, crimson, and a bad odor.
• Pelvic pain or discomfort during intercourse
• Pain in the lower abdomen

Screening Tests

Screening tests can aid in the detection of cervix cancer and precancerous cells that may develop into cervix cancer in the future. The majority of guidelines recommend starting screening for cervical cancer at the age of 21.

Screening tests include the following:

Pap test

A Pap test involves your doctor scraping and brushing cells from your cervix. It then goes through examination in a laboratory for abnormalities. A Pap test can reveal abnormal cells in the cervix. It also includes the cancer cells and cells that have changes that put them at risk of developing cervix cells.

HPV DNA test

The HPV DNA test involves examining cervix cells for infection with any of the HPV strains most likely to cause cervical cancer.

Diagnosis of Cervical Cancer

In case the doctor suspects cervical cancer, there will be various diagnostic tests the patient has through to confirm the presence of cancer.

Colposcopy

If you have certain symptoms that could indicate cancer, if your Pap test indicates malignant cells, or if your HPV test is positive, you will almost certainly require a colposcopy. The colposcope is a magnifying instrument which enables the doctor to examine the cervix's surface up close.

Biopsy

A biopsy can help diagnose cervical cancers. There are various biopsies to diagnose cervical cancer such as

Colonoscopy biopsy: For this, the cervix is initially inspected with a colposcope to identify any abnormal spots. A little (approximately 1/8-inch) portion of the abnormal region on the cervix's surface is excised with biopsy forceps.

Endocervical curettage (endocervical scraping): In the endocervical canal, a narrow device (either a curette or a brush) is introduced (the part of the cervix closest to the uterus). The curette or brush is used to scrape the interior of the canal, removing some tissue that is subsequently submitted to the lab for analysis.

Cone biopsy (conization): The doctor removes a cone-shaped portion of tissue from the cervix during this treatment, also known as conization. The exocervix (outside section of the cervix) forms the cone's base, while the endocervical canal forms the cone's point or apex. The transformation zone is in the tissue removed in the cone (the border between the exocervix and endocervix, where cervical pre-cancers and cancers are most likely to start). A cone biopsy can also help to eradicate many pre-malignancies and some early cancers.

Staging

If your doctor finds that you have cervical cancer, you will have additional tests to assess the degree (stage) of your disease. The stage of your cancer is an important consideration when deciding on treatment.

Imaging examinations

If your doctor suspects you have cervical cancer, he or she may order imaging tests to look inside your body. These tests can determine whether and where the disease has progressed, which will aid you and your doctor in developing a treatment strategy.

X-ray: To check if the cancer has spread to other parts of the body, an X-ray may be necessary.

CT (computed tomography): CT scans are typically when the tumour has become larger or in case of metastasis.

Magnetic resonance imaging (MRI): MRI scans can occasionally see soft tissue sections of the body better than other imaging procedures, such as a CT scan.

PET/CT scan: A PET scan in combination with a CT scan allows the doctor to compare high-radioactivity locations on the PET scan with a more comprehensive picture on the CT scan.

Conclusion

Cervical cancer is a form of cancer that develops in the cells of the cervix, which connects the uterus to the vagina. While in most cases, cervix cancer does not show symptoms during its early stages there are some symptoms we can look out for as mentioned above. Early diagnosis, staging and appropriate treatment can help in the successful treatment of cervical cancer.

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Reference:

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2. Mwaka AD, Orach CG, Were EM, Lyratzopoulos G, Wabinga H, Roland M. Awareness of cervical cancer risk factors and symptoms: cross-sectional community survey in post-conflict northern Uganda. Health Expect. 2016 Aug;19(4):854-67. doi: 10.1111/hex.12382. Epub 2015 Jul 23. PMID: 26205470; PMCID: PMC4957614.