CervicalCancerOverview

CervicalCancerOverview
Whatiscervicalcancer?
Cervicalcanceriscancerthat
startsinthecervix,thenarrow
openingintotheuterusfrom
thevagina.Thenormal
ectocervix(theportionofthe
uterusextendingintothe
vagina)isahealthypinkcolor
andiscoveredwithflat,thin
cellscalledsquamouscells.
Theendocervixorcervical
canalismadeupofanother
kindofcellcalledcolumnar
cells.Theareawherethese
cellsmeetiscalledthe
transformationzone(Tzone)andisthemostlikelylocationfor
abnormalorprecancerouscellstodevelop.
Mostcervicalcancers(80to90percent)aresquamouscellcancers.
Adenocarcinomaisthesecondmostcommontypeofcervicalcancer,
accountingfortheremaining10to20percentofcases.
Adenocarcinomadevelopsfromtheglandsthatproducemucusinthe
endocervix.Whilelesscommonthansquamouscellcarcinoma,the
incidenceofadenocarcinomaisontherise,particularlyinyounger
women.
Morethan12,000womenintheUnitedStateswillbediagnosedwith
cervicalcancereachyear,andmorethan4,000ofwomenwilldie.
Cervicalcanceristhesecondmostcommontypeofcancerforwomen
worldwide,butbecauseitdevelopsovertime,itisalsooneofthe
mostpreventabletypesofcancer.Deathsfromcervicalcancerinthe
UnitedStatescontinuetodeclinebyapproximately2percentayear.
ThisdeclineisprimarilyduetothewidespreaduseofthePaptestto
detectcervicalabnormalitiesandallowforearlytreatment.Mostwomen
whohaveabnormalcervicalcellchangesthatprogresstocervical
cancerhaveneverhadaPaptestorhavenothadoneintheprevious
threetofiveyears.
Cancerofthecervixtendstooccurduringmidlife.Halfofthewomen
diagnosedwiththediseasearebetween35and55yearsofage.It
rarelyaffectswomenunderage20,andapproximately20percentof
diagnosesaremadeinwomenolderthan65.Forthisreason,itis
importantforwomentocontinuecervicalcancerscreeninguntilatleast
theageof70.Somewomenneedtocontinuescreeninglonger,soask
yourhealthcareproviderwhatsbestforyou.

Whatcausescervicalcancer?
Humanpapillomavirus(HPV)isfoundinabout99%ofcervicalcancers.
Thereareover100differenttypesofHPV,mostofwhichareconsidered
lowriskanddonotcausecervicalcancer.HighriskHPVtypesmay
causecervicalcellabnormalitiesorcancer.Morethan70percentof
cervicalcancercasescanbeattributedtotwotypesofthevirus,HPV16
andHPV18,oftenreferredtoashighriskHPVtypes.
HPVisestimatedtobethemostcommonsexuallytransmittedinfection
intheUnitedStates.Infact,byage50approximately80%ofwomen
havebeeninfectedwithsometypeofHPV.Themajorityofwomen
infectedwiththeHPVvirusdoNOTdevelopcervicalcancer.Formost
womentheHPVinfectiondoesnotlastlong90%ofHPVinfections
resolveontheirownwithin2years.Asmallnumberofwomendonot
cleartheHPVvirusandareconsideredtohavepersistentinfection.A
womanwithapersistentHPVinfectionisatgreaterriskofdeveloping
cervicalcellabnormalitiesandcancerthanawomanwhoseinfection
resolvesonitsown.Certaintypesofthisvirusareabletotransform
normalcervicalcellsintoabnormalones.Inasmallnumberofcases
andusuallyoveralongperiodoftime(fromseveralyearstoseveral
decades),someoftheseabnormalcellsmaythendevelopintocervical
cancer.

SymptomsofCervicalCancer
Precancerouscervicalcellchangesandearlycancersofthecervix
generallydonotcausesymptoms.Forthisreason,regularscreening
throughPapandHPVtestscanhelpcatchprecancerouscellchanges
earlyandpreventthedevelopmentofcervicalcancer.
Possiblesymptomsofmoreadvanceddiseasemayincludeabnormalor
irregularvaginalbleeding,painduringsex,orvaginaldischarge.Notify
yourhealthcareproviderifyouexperience:
Abnormalbleeding,suchas
Bleedingbetweenregularmenstrualperiods
Bleedingaftersexualintercourse
Bleedingafterdouching
Bleedingafterapelvicexam
Bleedingaftermenopause
Pelvicpainnotrelatedtoyourmenstrualcycle
Heavyorunusualdischargethatmaybewatery,thick,and
possiblyhaveafoulodor
Increasedurinaryfrequency
Painduringurination
Thesesymptomscouldalsobesignsofotherhealthproblems,not
relatedtocervicalcancer.Ifyouexperienceanyofthesymptomsabove,
talktoahealthcareprovider.

CervicalCancer101
ForanoverviewofHPVandcervicalcancer,clickheretoviewthe
slidesfromapresentationmadebyDr.LoisRamondettaatthe2013
NCCCNationalConference.Dr.RamondettaisaProfessorof
GynecologicOncologyattheM.D.AnderCancerCenterinHouston,TX,
andtheChiefoftheDivisionofGynecologicOncologyattheLyndon
BainesJohnsonHospital,alsoinHouston.