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cervical cancer

Dr Norain Ishak, Primary Care Doctor

1 January, 2024

Cervical cancer is a type of cancer that occurs in the cells of the cervix, the lower part of the uterus connecting to the vagina. It is a significant health concern for women worldwide but is also one of the most preventable and treatable forms of cancer when detected early.

Risk Factors for Cervical Cancer

HPV infection

Nearly all people who are sexually active will become infected with HPV at some point in their lives. Typically, the immune system effectively clears most HPV infections within a year or two. Short-term infections, resolved by the immune system, do not pose a cancer risk. However, a prolonged high-risk HPV infection can cause alterations in cervical cells, leading to the formation of precancerous lesions. If these lesions go undetected and untreated, there is a potential progression to cervical cancer over time. Thus, HPV vaccination is recommended for female age 9 to 45 years old of age for prevention of cervical cancer caused by certain type of HPV.

Smoking

Tobacco by-products have been found in the cervical mucus of women who smoke. Researchers believe that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections.

A weakened immune system

Women with HIV/AIDS or those taking drugs to suppress their immune response, such as those being treated for an autoimmune disease are at risk of cervical cancer

Long-term use of birth control pills

There is evidence that taking oral contraceptives (OCs) for a long time increases the risk of cancer of the cervix.

Multiple full-term pregnancy

Women with three or more full-term pregnancies are at an increased risk of cervical cancer, likely due to heightened exposure to HPV during sexual activity. Hormonal changes in pregnancy may also increase susceptibility to HPV infection or cancer growth. Additionally, weakened immune systems during pregnancy could contribute to HPV infection and cancer development.

Sexual history

Becoming sexually active at a young age especially younger than 18 years old, multiple sexual partners or having one partner who is having HPV infection can increase the risk of cervical cancer due to more exposure with HPV infection

Symptoms of Cervical Cancer

In its early stages, cervical cancer may not exhibit any symptoms. However, as the cancer progresses, women may experience:

Abnormal vaginal bleeding:
This includes bleeding between periods, after menopause, or post-sexual intercourse.
Pelvic pain and pain during intercourse:
Women with cervical cancer may experience discomfort or pain in the pelvic region, especially during sexual activity.
Unexplained weight loss and fatigue:
As the cancer advances, it may lead to weight loss and persistent fatigue.
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Early Detection with Pap smear and HPV Testing

Early diagnosis significantly improves the chances of successful treatment. The most common screening method is the Pap smear, where a sample of cervical cells is collected and examined for abnormalities.

Additionally, an HPV test may be conducted to detect the presence of high-risk human papillomavirus, a leading cause of cervical cancer. If abnormalities are identified, a colposcopy is often performed—a procedure to closely examine the cervix.

Further confirmation comes from a biopsy, where a small tissue sample is collected and analysed in a laboratory to determine the presence of cancerous cells.

Staging of Cervical Cancer

Cervical cancer is typically staged from 0 to IV, indicating the extent and severity of the disease. Staging helps healthcare professionals determine the most appropriate treatment plan.

Stage 0 (Carcinoma in situ)

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Abnormal cells are found only in the innermost lining of the cervix.

Stage I

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Cancer is confined to the cervix.

Stage II

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Cancer has spread beyond the cervix to nearby tissues.

Stage III

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Cancer extends to the lower part of the vagina or the walls of the pelvis.

Stage IV

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Cancer has spread to distant organs like the bladder or rectum.

Understanding cervical cancer and taking proactive steps can significantly impact women’s health. Early detection through screenings and preventive measures is key. Stay informed, undergo routine screenings, and adopt a healthy lifestyle to reduce your risk. Remember, early detection saves lives.

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