Cancer of the cervix — the lower, narrow part of the uterus (womb) that protrudes into the vagina, and that serves as a passageway for the fetus during delivery — is a common form of cancer in women. In recent years, however, the incidence of the illness has markedly declined primarily because more women have taken to undergoing Pap test on a regular basis. The Pap test is a very effective screening test for cervical cancer. The procedure detects changes in the cervix even before they become malignant or cancerous.
The exact cause of cervical cancer is still unknown, but there are predisposing factors to the disease that have already been identified. Among these are age — most cervical cancers occur in women above 40 — and becoming sexually active at a very young age (15-20 years). But the main risk factor for cervical cancer is infection with Human papilloviruses (HPVs). In fact, almost all cases of cervical cancers are triggered by infection with an HPV.
HPV is a group of viruses that can infect the cervix and cause changes — often benign but sometimes malignant — in the cells of this organ. Infection with HPVs usually does not manifest any symptom, although some HPVs produce genital warts.
As a rule, HPVs are transmitted through sexual intercourse, but HPV viruses are so common, in both men and women, that most adults have been infected with HPV sometime in their lives. In women, most HPV infections, especially among women below 30 years of age, are dealt with by the body’s defense system such that most disappear without causing any permanent damage to the cervix.
However, occasionally an HPV infection produces abnormal changes in the cells of the cervix which later on can degenerate into malignancy. An HPV infection has a higher chance of causing malignant (cancerous) changes in women who: smoke, have used birth control pills for 5 or more years, have many children, have had many sexual partners or have had sex with a man who has had many sexual partners.
In its early stages, cancer of the cervix does not produce any symptoms. Later stages cause vaginal bleeding (often painless), vaginal discharge, pain in the pelvic area and pain during intercourse.
Diagnosis of cervical cancer is often established by biopsy which consists of obtaining a small amount of tissue sample from the cervix that is then examined under the microscope.
From the time initial abnormal changes in the cells of the cervix occur till the time the cells become cancerous and become invasive takes many years. But once the cancer cells have spread the disease progresses very fast and, if untreated, results in death in three to five years. Treatment of advance cervical cancer is complicated and failure rate (as proven by what happened to your neighbor) is high. Fortunately, there is now a way of detecting the initial abnormal changes in the cells of the cervix and treating these changes before they become cancerous.
The most effective test for detection of abnormal cervical cells is Pap test. This test is inexpensive and painless. It is often performed as part of an internal gynecologic examination. In Pap test, the doctor scrapes a sample of cells from the cervix with the use of cotton or spatula and then smears the cells on a glass slide. Alternately, the cells are rinsed into a small container of liquid. Later, the cells are placed onto slide by a machine. In any case, the cells on the slides are examined under a microscope for abnormalities.
Regular Pap test can reduce a woman’s risk of acquiring cervical cancer to practically nil. At present, it is recommended that women should start undergoing the test three years after becoming sexually active or when they reach age 21 (whichever comes first). The test should be performed once a year at the most, In fact, for most women the current recommendation is to have the test only every three years.
Needless to say, I advise all women to undergo Pap test on a regular basis. There is no longer any reason for any woman to die from an easily preventable disease like cervical cancer.
