Cervical Cancer

Cervical cancer is a malignant cancer of the cervix. It can also be easily detected by regular screening. However, most women who develop cervical cancer have not been screened in the three years prior to their diagnosis. Only some women with pre-cancerous changes of the cervix will develop cancer. This process usually takes several years but sometimes can happen in less than a year. For most women, pre-cancerous cells will remain unchanged and go away without any treatment. But if these precancers are treated, almost all true cancers can be prevented.

Cervical Cancer Facts

The cervix is the lower part of the uterus leading into the vagina. This is an area where cells change rapidly, and where malignant cell changes are most likely to occur. While cervical cancer is the tenth most common cancer among Canadian women of all ages, it is the third most common among women aged 20 to 49.

The Papanicolaou (Pap) smear test is used to detect changes in the cervix before they become cancerous or when they are at a stage when treatment can be effective. Since the introduction of the Pap test more than 25 years ago, the death rate from cervical cancer has declined dramatically, dropping almost 50 percent. The survival rate is 74 percent over five years.

However, approximately 1,450 Canadian women will receive a diagnosis this year of invasive cervical cancer, and approximately 420 women will die from this disease. Woman who are older (aged 40-59), immigrant, Aboriginal or have a lower socio-economic status are at higher risk of developing cervical cancer, primarily because they have not been screened at all or have been screened irregularly.

Symptoms of Cervical Cancer

The early stages of cervical cancer may be completely asymptomatic (without symptoms). Vaginal bleeding, contact bleeding or (rarely) a vaginal mass may indicate the presence of malignancy. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere.

Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, single swollen leg, heavy bleeding from the vagina, leaking of urine or feces from the vagina, and bone fractures.

Risk Factors For Cervical Cancer

The risk factors for cervical cancer are similar to those for sexually transmitted diseases. You are more likely to develop cervical cancer if you have multiple sexual partners or if you become sexually active at an early age. Early sexual activity is believed to increase the risk because during puberty, cervical tissue undergoes many changes that might make the area more vulnerable to damage.

Male partners of cervical cancer patients report many more sexual partners than those of women without the disease.

Infection with human papillomavirus (HPV) increases your risk 20 to 100 times. HPV is a sexually transmitted virus that is quite common, especially among younger women. However, there are over 100 types of HPV and only a few are high risk types. Only a fraction of women infected with high risk types will develop cervical cancer.

In some studies, cigarette smoking has been found to increase the risk.

Using barrier-type contraceptive methods, such as condoms or a diaphragm, instead of oral contraceptives lowers your risk.

Minimizing Your Risk of Cervical Cancer

To Minimize your risk of cervical cancer, follow the following health guidelines:

• Have a Pap test at age 18 as part of your routine health examination, or as soon as you become sexually active. A second test should be taken after one year, especially if you begin screening after age 20.

• If your first two tests show no abnormality, you should be re-screened every three years to age 69. However, you do not need to be re-screened if you have never had sexual intercourse or if you have had a hysterectomy and your previous tests were normal.

• If you are over the age of 69, and have had at least two clear Pap tests, no cervical abnormalities for nine years and no history of cancer, you do not need regular screening.

• If an abnormality is detected during a Pap test, you should be re-tested every six months for two years.

• Limit your number of sexual partners and be aware of your partners' sexual history.

• Limit your number of unprotected sexual encounters. Using condoms also lowers your risk.