Cervical cancer happens when cells change in a woman’s cervix, which connects her uterus with her vagina. This cancer can affect the deeper tissues of her cervix and may spread to other parts of her body (metastasize), often the lungs, liver, bladder, vagina, and rectum.
Most cases of cervical cancer are caused by infection with human papillomavirus (HPV), which is preventable with a vaccine.
Cervical cancer grows slowly, so there’s usually time to find and treat it before it causes serious problems. It kills fewer and fewer women each year, thanks to improved screening through Pap tests.
Women 35 to 44 years old are most likely to get it. More than 15% of new cases are in women over age 65, however, especially those who haven’t been getting regular screenings.
Cervical cancer is a type of cancer that starts in the cervix. The cervix is a hollow cylinder that connects the lower part of a woman’s uterus to her vagina. Most cervical cancers begin in cells on the surface of the cervix.
The cervix is made of two parts and is covered with two different types of cells.
The place where these two cell types meet in the cervix is called the transformation zone. The exact location of the transformation zone changes as you get older and if you give birth. Most cervical cancers begin in the cells in the transformation zone.
Cells in the transformation zone do not suddenly change into cancer. Instead, the normal cells of the cervix first gradually develop abnormal changes that are called pre-cancerous. Doctors use several terms to describe these pre-cancerous changes, including cervical intraepithelial neoplasia (CIN), squamous intraepithelial lesion (SIL), and dysplasia.
When the pre-cancers are checked in the lab, they are graded on a scale of 1 to 3 based on how much of the cervical tissue looks abnormal.
Although cervical cancers start from cells with pre-cancerous changes (pre-cancers), only some of the women with pre-cancers of the cervix will develop cancer. For most women, pre-cancerous cells will go away without any treatment. But, in some women pre-cancers turn into true (invasive) cancers. Treating cervical pre-cancers can prevent almost all cervical cancers.
Pre-cancerous changes can be detected by the Pap test and treated to prevent cancer from developing. See Can Cervical Cancer Be Prevented? Pre-cancerous changes found on your Pap test and specific types of treatment for pre-cancers are discussed in The Pap Test and Work-up of Abnormal Pap Test Results.
Cervical cancers and cervical pre-cancers are classified by how they look in the lab s with a microscope. The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma.
Although almost all cervical cancers are either squamous cell carcinomas or adenocarcinomas, other types of cancer also can develop in the cervix. These other types, such as melanoma, sarcoma, and lymphoma, occur more commonly in other parts of the body.
Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.
HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms so you can’t tell that you have it. For most women, HPV will go away on its own; however, if it does not, there is a chance that over time it may cause cervical cancer.
Other things can increase your risk of cervical cancer—
Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA. A cell’s DNA contains the instructions that tell a cell what to do.
Healthy cells grow and multiply at a set rate, eventually dying at a set time. The mutations tell the cells to grow and multiply out of control, and they don’t die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body.
It isn’t clear what causes cervical cancer, but it’s certain that HPV plays a role. HPV is very common, and most people with the virus never develop cancer. This means other factors — such as your environment or your lifestyle choices — also determine whether you’ll develop cervical cancer.
Cervical cancer is very treatable if you catch it early. The four main treatments are:
Sometimes these treatments are combined to make them more effective.
The purpose of surgery is to remove as much of the cancer as possible. Sometimes the doctor can remove just the area of the cervix that contains cancer cells. For cancer that’s more widespread, surgery may involve removing the cervix and other organs in the pelvis.
Radiation kills cancer cells using high-energy X-ray beams. It can be delivered through a machine outside the body. It can also be delivered from inside the body using a metal tube placed in the uterus or vagina.
Chemotherapy uses drugs to kill cancer cells throughout the body. Doctors give this treatment in cycles. You’ll get chemo for a period of time. You’ll then stop the treatment to give your body time to recover.
Bevacizumab (Avastin) is a newer drug that works in a different way from chemotherapy and radiation. It blocks the growth of new blood vessels that help the cancer grow and survive. This drug is often given together with chemotherapy.
If your doctor discovers precancerous cells in your cervix they can be treated. See what methods stop these cells from turning into cancer.
After you’ve been diagnosed, your doctor will assign your cancer a stage. The stage tells whether the cancer has spread, and if so, how far it’s spread. Staging your cancer can help your doctor find the right treatment for you.Cervical cancer has four stages:
Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21.
Screening tests include:
Discuss your cervical cancer screening options with your doctor.
If cervical cancer is suspected, your doctor is likely to start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells.
During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:
If the punch biopsy or endocervical curettage is worrisome, your doctor may perform one of the following tests:
To reduce your risk of cervical cancer: