What is Cervical Cancer?
Definition
What is Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. This malignancy develops when abnormal cells on the cervix grow uncontrollably .
Relevance and Importance
Cervical cancer is a significant public health issue worldwide. It is the fourth most common cancer in women, with thousands of new cases diagnosed annually. Early detection and vaccination against human papillomavirus (HPV), a major cause of cervical cancer, are critical for prevention and management.
Types and Categories
Squamous Cell Carcinoma
This type is the most common, accounting for about 70-90% of all cervical cancers. It begins in the thin, flat cells lining the outer part of the cervix.
Adenocarcinoma
Adenocarcinoma starts in the glandular cells that line the cervical canal. It is less common but tends to be more aggressive than squamous cell carcinoma.
Adenosquamous Carcinoma
This type has features of both squamous cell carcinoma and adenocarcinoma. It is rare and often diagnosed at an advanced stage.
Small Cell Carcinoma
A rare and highly aggressive form of cervical cancer that can spread quickly to other parts of the body.
Causes of Cervical Cancer
Cervical cancer primarily arises from long-term infection with certain types of human papillomavirus (HPV), but several other factors can increase the risk. Here are the main causes and risk factors for cervical cancer:
1. Human Papillomavirus (HPV) Infection
HPV Overview
HPV is a group of more than 200 related viruses, some of which are spread through direct sexual contact. HPV types 16 and 18 are responsible for approximately 70% of cervical cancer cases.
Transmission
HPV is transmitted through skin-to-skin contact during vaginal, anal, or oral sex with someone who has the virus. It is one of the most common sexually transmitted infections (STIs).
Persistence of HPV
While most HPV infections are transient and cleared by the immune system, persistent infections with high-risk HPV types can cause cervical cell changes that may develop into cancer over time.
2. Sexual Behaviour
Multiple Sexual Partners
Having multiple sexual partners increases the risk of HPV infection. The likelihood of encountering someone with HPV rises with the number of partners.
Early Sexual Activity
Engaging in sexual activity at a young age increases the risk of HPV infection, as the cervix in younger women is more susceptible to the virus.
3. Smoking
Impact on the Immune System
Smoking weakens the immune system, making it less effective at fighting HPV infections. Smokers are about twice as likely as non-smokers to develop cervical cancer.
Direct Damage to Cervical Cells
Chemicals in tobacco smoke can damage the DNA of cervical cells, contributing to the development of cancerous changes.
4. Immunosuppression
HIV and Other Conditions
Women with weakened immune systems, such as those with HIV/AIDS, are at higher risk of HPV infections leading to cervical cancer. Immunosuppressive drugs, often used after organ transplants, can also increase the risk.
5. Family History of Cervical Cancer
Genetic Predisposition
A family history of cervical cancer can suggest a genetic predisposition. Women with relatives who have had cervical cancer are at a higher risk.
6. Long-term Use of Oral Contraceptives
Hormonal Influence
Using birth control pills for five or more years can slightly increase the risk of cervical cancer. Hormones in these pills may influence the development of cervical cancer by affecting the cells of the cervix.
7. Other Sexually Transmitted Infections (STIs)
Chlamydia and Gonorrhea
Having other STIs, such as chlamydia or gonorrhea, can increase the risk of HPV infection and subsequently cervical cancer.
8. Socioeconomic Factors
Access to Healthcare
Women in lower socioeconomic groups may have less access to healthcare, including preventive measures like Pap smears and HPV vaccinations, increasing their risk of developing cervical cancer.
Awareness and Education
Lack of awareness about HPV and cervical cancer prevention methods can contribute to higher incidence rates in certain populations.
9. Exposure to Diethylstilbestrol (DES)
Maternal Use of DES
Women whose mothers took the drug diethylstilbestrol (DES) during pregnancy to prevent miscarriage are at an increased risk of developing a rare type of cervical and vaginal cancer.
10. Poor Diet and Lack of Exercise
Nutritional Deficiencies
A diet low in fruits and vegetables may be associated with an increased risk of cervical cancer. Proper nutrition supports a healthy immune system, which is crucial in fighting off HPV infections.
Physical Inactivity
Lack of exercise can contribute to obesity, which has been linked to an increased risk of several cancers, including cervical cancer.
Symptoms and Signs
Early Symptoms
Early-stage cervical cancer generally produces no symptoms. Regular screening is crucial for early detection.
Advanced Symptoms
- Abnormal Vaginal Bleeding: Including bleeding after intercourse, between menstrual periods, or post-menopause.
- Unusual Discharge: A watery, pink, or foul-smelling discharge.
- Pelvic Pain: Especially during intercourse or at other times.
Less Common Symptoms
- Leg pain or swelling
- Difficulty urinating or blood in urine
- Weight loss and fatigue
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Causes and Risk Factors
Human Papillomavirus (HPV)
HPV infection is the most significant risk factor for cervical cancer. Nearly all cases of cervical cancer are associated with HPV.
Sexual Behaviour
Multiple sexual partners and early sexual activity increase the risk of HPV infection.
Smoking
Smoking doubles the risk of cervical cancer as it damages the DNA of cervix cells and weakens the immune system.
Immunosuppression
Women with weakened immune systems, such as those with HIV, are at higher risk.
Family History
A family history of cervical cancer can increase the risk, suggesting a genetic predisposition.
Long-term Use of Oral Contraceptives
Long-term use of birth control pills is associated with an increased risk of cervical cancer.
Diagnosis and Tests
Pap Smear
A Pap test involves scraping cells from the cervix to be examined for abnormalities. It’s a primary screening tool for cervical cancer.
HPV DNA Test
This test detects the presence of HPV in cervical cells, identifying women at higher risk for cervical cancer.
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