Cervical Cancer

What is Cervical Cancer?

Cancer of the cervix affects the cells lining the entrance to the womb.

Cervical cancer develops in a series of pre-cancerous changes, starting with mild abnormalities in the cells and progressing towards full cancer. Each year, more than 20,000 women are found to have the most serious form of pre-cancerous abnormalities (CIN 3 changes) when they have a cervical smear test. By catching these changes before cancer has fully established, cervical screening now saves approximately 4,500 lives per year in England.

About 70 per cent of women treated for invasive cervical cancer are alive five years later, although survival rates are much higher when the disease is caught in its earlier stages.

Causes

  • Infection with certain types of human papilloma virus (HPV), but not the type that causes genital warts. HPV is found in around 95 per cent of cases of cervical cancer.
  • Any factor that increases the risk of exposure to HPV, including having many sexual partners, first having sex at a young age and not using barrier contraceptives such as condoms.
  • Smokers are twice as likely to develop the disease as non-smokers because chemicals in cigarette smoke damage special cells in the cervix that normally fight the disease. For help and advice to give up smoking see Addictions.
  • The contraceptive pill directly increases the risk by a very small amount.
  • Not having a smear test. Almost half of all new cases of cervical cancer occur in women who’ve never had a smear test.

Symptoms

The most common symptoms of cervical cancer include:

  • Bleeding between periods or after sex, or new bleeding after the menopause.
  • Unpleasant smelling vaginal discharge.
  • Discomfort/pain during intercourse.

Any of these symptoms may have causes other than cervical cancer, but it is important to get them checked by your GP, even if you’ve attended your routine cervical smear test.

Diagnosis

All women aged 20 to 64 who’ve had sexual intercourse should have a smear test every three to five years. This can be taken by a doctor or nurse at your GP’s surgery, family planning clinic or well woman clinic.

The NHS Cervical Screening Programme is currently changing arrangements so that women will first be invited to have a smear at 25. After that they will be offered screening every 3 years until 49, and then every 5 years until 64. Women over 64 can stop having smear tests if the previous two in the past ten years were negative.

Smear tests detect the early changes of cervical cancer. Sometimes all that’s needed is to repeat the test a few months later to see if the abnormalities have healed. However, most women will be offered further tests, in particular a colposcopy where the doctor examines the cervix with a microscope to get a closer look at the cells and take a biopsy (rather like a more intensive smear test).

Treatments

The treatment recommended will depend on the stage of the cancer, but generally aims to destroy or remove the abnormal cells. Treatments for pre-cancerous changes include laser, cryotherapy (freezing), cone biopsy (removing a cone-shaped piece of tissue) and hysterectomy. In invasive cancer, radiotherapy and chemotherapy may be offered.

 

This article was last medically reviewed by Dr Trisha Macnair in August 2005.
First published in November 1997.