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Cervical cancer
starts in the cervix, which is the lower part of the uterus that opens at the top of the vagina. Cervical cancer is the third most common type of cancer in women worldwide. It’s much less common in the United States due to routine use of Pap smears, which can identify potentially precancerous changes. Cervical cancers start in the cells on the surface of the cervix. There are two types of cells on the cervix's surface: squamous and columnar. The majority of cervical cancers are from squamous cells. Early cervical cancer usually has no symptoms, however symptoms that may occur include:
Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling
Abnormal vaginal bleeding between periods, after intercourse, or after menopause
Periods become heavier and last longer than usual
Any bleeding after menopause
Symptoms of advanced cervical cancer may include:
Loss of appetite
Weight loss
Fatigue
Pelvic pain
Back pain
Cervical cancer is very slow growing and starts as a pre-cancerous condition called dysplasia. This pre-cancerous condition can be detected by a Pap smear and is 100% treatable. Most women that are diagnosed with cervical cancer today have not had regular Pap smears or they have not followed up on abnormal results. Undetected, pre-cancerous changes can develop into cervical cancer and spread to the bladder, intestines, lungs, and liver, which is why it’s so important for women to get regular Pap smears. It can take years for pre-cancerous changes to turn into cervical cancer.
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, however, only certain strains of HPV actually lead to cervical cancer. Other strains of HPV may cause genital warts. The HPV vaccine may prevent infection with certain species of HPV associated with the development of cervical cancer, genital warts and some less common cancers. The two HPV vaccines currently on the market are Gardasil and Cervarix. Both protect against HPV-16 and HPV-18 that cause 70 percent of cervical cancers. Public health officials in the United States, Canada, Australia and Europe recommend vaccination of young women against HPV to prevent cervical cancer, and to reduce the number of painful and costly treatments caused by HPV. Worldwide, HPV is the most common sexually transmitted infection in adults.
Other risk factors for cervical cancer include:
Having sex at an early age
Multiple sexual partners
Sexual partners who have multiple partners or who participate in high-risk sexual activities
Women whose mothers took the drug DES (diethylstilbestrol) during pregnancy in the early 1960s to prevent miscarriage
Weakened immune system
Poor economic status (may not be able to afford regular Pap smears)
Microinvasive cancer (stage IA) is usually treated by hysterectomy. For stage IA2, the lymph nodes are also removed. An alternative for patients who desire to remain fertile is a local surgical procedure such as a loop electrical excision procedure (LEEP) or cone biopsy. Prognosis for cervical cancer depends on the stage of the cancer. With treatment, the five-year survival rate for the earliest stage is 92%, and the overall (all stages combined) 5-year survival rate is about 72%. With treatment, 80 to 90% of women with stage I cancer and 50 to 65% of those with stage II cancer are alive 5 years after diagnosis.
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