What is cervical cancer?

The cervix is the lower part of the uterus (womb). It is sometimes called the uterine cervix. The body of the uterus (the upper part) is where a baby grows. The cervix connects the body of the uterus to the vagina (birth canal). The part of the cervix closest to the body of the uterus is called the endocervix. The part next to the vagina is the exocervix (or ectocervix). The 2 main types of cells covering the cervix are squamous cells (on the exocervix) and glandular cells (on the endocervix). The place where these 2 cell types meet is called the transformation zone. Most cervical cancers start in the transformation zone

Most cervical cancers begin in the cells lining the cervix. These cells do not suddenly change into cancer. Instead, the normal cells of the cervix first gradually develop pre-cancerous changes that turn into cancer. Doctors use several terms to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia. These changes can be detected by the Pap test and treated to prevent the development of cancer (see “Can cervical cancer be prevented?”).

Causes, incidence, and risk factors

Worldwide, cervical cancer is the third most common type of cancer in women.

Cervical cancer starts in the cells on the surface of the cervix. There are two types of cells on the cervix’s surface: squamous and columnar. Most cervical cancers are from squamous cells.

Cervical cancer usually develops very slowly. It starts as a precancerous condition called dysplasia. This precancerous condition can be detected by a Pap smear and is 100% treatable. That is why it is so important for women to get regular Pap smears. Most women who are diagnosed with cervical cancer today have not had regular Pap smears or they have not followed up on abnormal Pap smear results.

Undetected precancerous changes can develop into cervical cancer and spread to the bladder, intestines, lungs, and liver. It can take years for precancerous changes to turn into cervical cancer. Patients with cervical cancer do not usually have problems until the cancer is advanced and has spread.

Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that is spread through sexual intercourse. There are many different types of HPV. Some strains lead to cervical cancer. (Other strains may cause genital warts, while others do not cause any problems at all.)

Risk factors for cervical cancer include:

Having sex at an early age
Multiple sexual partners
Poor economic status (may not be able to afford regular Pap smears)
Multiple sexual partners are those who participate in high-risk sexual activities
Women whose mothers took the drug DES (diethylstilbestrol) during pregnancy in the early 60s to prevent miscarriage
Weakened immune system

Symptoms

Most of the time, early cervical cancer has no symptoms. Symptoms that may occur include:

Abnormal vaginal bleeding between periods, after intercourse, or after menopause
Any bleeding after menopause
Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling
Periods become heavier and last longer than usual

Symptoms of advanced cervical cancer may include: