Everything you need to know about cervical cancer – including why it’s so important to keep up to date with your cervical screening appointments.
Approximately 3,200 cases of cervical cancer are diagnosed each year in the UK, making it the twelfth most common cancer in women in the UK. It’s most common in sexually active women between the ages of 30 and 45, and trans men who have not had a full hysterectomy (the removal of both the womb and cervix) are also susceptible.
But what causes cervical cancer, what are the symptoms and – importantly – is it preventable?
Mr Richard Slade, gynaecologist and obstetrician at The Christie Private Care, part of HCA Healthcare UK, looks at the symptoms, treatment and prevention of cervical cancer:
What is cervical cancer and what causes it?
Cancer of the cervix (cervical cancer) develops in a woman’s cervix (the neck of the womb at the top of the vagina) and mostly affects sexually active women aged between 30 and 45. It occurs when abnormal cells in the lining of the cervix grow in an uncontrolled way.
The major cause of cervical cancer is the human papilloma virus (HPV). There are many different types of HPV, and most women will contract some type of the infection at some point in their lives – many won’t even know they have it.
Cervical cancer occurs when abnormal cells in the lining of the cervix grow in an uncontrolled way.
However, there are at least 15 types of HPV that have a high-risk of causing cervical cancer. These types are thought to prevent the cells from working normally, eventually causing them to reproduce at an uncontrollable rate and leading to the growth of a cancerous tumour.
Further risk factors, aside from the HPV infection, which can increase a women’s chance of developing cervical cancer include smoking and having a weakened immune system.
Why is cervical screening so important?
Cervical cancer is one of the few types of cancers that can actually be prevented. This is the point of cervical screening (also known as smear tests).
In the UK, between the ages of 25 and 64, every woman who is registered with a GP is invited to undergo cervical screening. This will occur every three years until the age of 50, when it decreases to every five years.
Cervical screening usually lasts around 10 minutes, but the actual procedure will only last a couple of minutes. It involves an instrument called a speculum, which the nurse/doctor will gently use to open your vagina, allowing them to see your cervix. A small brush will then be used to take a sample of cells from your cervix, which will be sent to the lab for testing.
Essentially, cervical screening works by detecting abnormal changes to the cells of your cervix (the neck of your womb). Picking up any changes early on means careful monitoring can be implemented, to ensure they don’t develop into cervical cancer.
The earlier changes in cells are picked up, the lower the chance of the cells developing into cancerous cells. Attending your cervical screening appointments is one of the best ways to protect yourself from cervical cancer.
Cervical cancer signs and symptoms
Symptoms do not tend to appear in the early stages of cervical cancer, and most women will not have any signs or symptoms of a pre-cancer (abnormal cells), which is why it’s so important to attend your cervical screening appointment.
Later, signs of cervical cancer may include:
- Changes in your menstrual cycle (for example, your periods being heavier and lasting longer than usual).
- Spotting or light bleeding between your periods.
- Increased vaginal discharge.
- Pain during sexual intercourse.
- Bleeding after sexual intercourse.
It’s important to note that abnormal bleeding can be caused by many different factors and is not always a sign of cervical cancer – but it’s always worth getting it checked out with your GP or gynaecologist as soon as possible.
Cervical cancer diagnosis
It’s important to note that an abnormal cervical screening result does not mean you have cervical cancer, as cells in the cervix are changing all the time. However, if it’s suspected that you may have cervical cancer, you will receive a thorough examination of your cervix, which will usually take up to 20 minutes.
An abnormal result does not mean you have cervical cancer, as cells in the cervix are changing all the time.
During this examination, a colposcope (a large magnifying glass) will be used, which enables the doctor to look closely at the skin-like covering of the cervix, allowing them to notice changes that may be too small to see with the naked eye alone, and determine where there are any abnormal looking cells. This is a painless examination for most women.
The doctor will also take a biopsy (sample of cervical cells) for testing from any areas of the cervix that appear abnormal. The biopsy is also usually painless, but can cause a cramp-like pain for a few minutes following the procedure.
Cervical cancer treatment
Receiving an abnormal result from your smear test does not mean you have cancer. It simply means that there are some abnormalities in the cells of the cervix. Catching these abnormalities early means they can be monitored and treated before they develop further.
In terms of treating pre-cancerous cells, mild changes to the cervix will often return to normal on their own, without having any form of treatment.
With more severe pre-cancerous cells, a loop electrosurgical excision procedure (LEEP) may be used as treatment. This procedure removes the abnormal cells by using electrosurgery.
If a biopsy indicates abnormalities have progressed to cancer, further tests will be carried out to determine the stage and best course of treatment.
There are various different treatments for cervical cancer, and the chosen treatment depends on the stage of the cancer, other health problems and also the patient’s own preferences.
If the cancer is in the early stages, it will most likely be treated with surgery. The size of the cancer will determine which operation is best. For very small cervical cancer, surgery can be used to cut away the cancer through a cone biopsy. Early-stage cervical cancer can also be treated by having surgery to remove the cervix (trachelectomy) or surgery to remove the cervix and uterus (hysterectomy). However, whilst the latter can cure early stage cervical cancer and prevent recurrence, it also makes it impossible to become pregnant.
Aside from surgery, treatment options also include radiation therapy and chemotherapy, to try to kill the cancer cells.
Cervical cancer prevention
While there’s no one way to prevent yourself from developing cervical cancer, there are a number of things you can do to minimalise your risk:
✔️ Regular cervical screening
This is the most effective way to pick up any abnormal changes in good time, while the abnormal cells are still in their early stages. Attending your cervical screening appointment is imperative.
✔️ Take note of any unusual symptoms
This includes bleeding between periods or any abnormal discharge, because although screening is mostly correct, it is not 100 per cent accurate.
✔️ Ensure young girls have the cervical cancer vaccination
This vaccination protects against four different types of HPV, including the two that are responsible for most cases of cervical cancer. The vaccination is given to girls when they are 12 to 13 years old. However, while it can considerably reduce the risk of cervical cancer, it is not a guarantee and cervical screening (smear) tests should still be attended.
✔️ Practise safe sex
Having safe sex will minimise your chances of developing HPV, which is commonly linked to the development of cervical cancer. This means using a condom.
✔️ Stop smoking
Avoiding smoking reduces your chance of developing cervical cancer, as certain chemicals in cigarettes (benzyrenes) are known to damage the cervix.