What Is Cervical Cancer?

Cancer happens when cells in the body change and grow out of control. These cells can form lumps called tumors. Cancer that starts in cells of the cervix is called cervical cancer. The cervix is the narrow lower end of the uterus. It connects the uterus to the vagina.

Cervical cancer can spread from the cervix to other parts of the body. This spread is called metastasis. The more cancer spreads, the harder it is to treat.

When cells in the cervix start to change and grow in ways that aren't normal, it's called cervical dysplasia or cervical intraepithelial neoplasia (CIN). Dysplasia isn't cancer. But if the abnormal cells continue to change, grow, and then spread, it can become cancer if not treated.

There are 3 kinds of cervical cancer:

• Squamous cell carcinoma. This type starts in the thin, flat cells on the outer surface of the cervix. It's by far the most common kind of cervical cancer.
• Adenocarcinoma. This type starts in glandular cells that line the inside of the cervix. It is the second most common type.
• Mixed carcinoma or adenosquamous carcinoma. This kind is made up of both of the types listed above.

In most people, cervical cancer is caused by a long-term infection with the human papillomavirus (HPV). HPV infection is very common and often goes away on its own. But in some cases, over time, HPV infection may continue. And it may lead to cervical dysplasia and then to cervical cancer. HPV infection is strongly linked to cervical cancer. There are over 100 types of HPV. The HPV types most often linked with cervical cancer are HPV-16 and HPV-18, although there are others. But it's important to know that most people with HPV don't develop cervical cancer.

Other risk factors include:

• Smoking.
• Being overweight or having obesity.
• Using birth control pills (oral contraceptives) for a long time.
• Having had a sexually transmitted infection, such as chlamydia or herpes.
• Having a weak immune system.
• Having many sexual partners.
• Having 3 or more full-term pregnancies.
• Being sexually active at an early age (especially before 18 years old).
• Having a family history of cervical cancer (parent or sibling had it).

Not all these risk factors may directly cause cervical cancer. But they may be linked to other risk factors, like exposure to HPV, which does cause cervical cancer. Talk with your doctor about your own risk for cervical cancer.

There are several ways to prevent cervical cancer.

• Get screening tests. Regular screening can help find cervical cell changes before they become cancer. Treating these changes can keep cancer from starting. Cervical cancer grows slowly. So regular testing can also help find this cancer early, when it's small and easier to treat. Testing options include an HPV test, HPV/Pap cotest, or Pap test.
• Get the HPV vaccine. A vaccine can prevent HPV and HPV-linked cancers. It can be given to anyone, no matter their sex. To work best, the vaccine should be given at or before age 11 or 12, before the first possible exposure to the virus. It can be given starting at age 9. It's also recommended for everyone through age 26, if not vaccinated already. The vaccine is approved by the FDA up to age 45 for people who haven't been vaccinated. Ask your doctor about the vaccine if you haven't had it.
• Use condoms. Condoms can decrease the risk of the spread of HPV. But they do not completely prevent the spread. It is still possible in areas the condom does not cover, such as the skin in the anal or genital area. Condoms need to be used correctly, and used every time you have sex.
• Don't smoke. Smoking has been linked to cervical precancer and cancer.

In early stages of cervical cancer, most people don't have any symptoms. As the tumor grows or the cancer spreads, the most common symptoms are:

• Abnormal vaginal bleeding.
• Increased vaginal discharge.
• Pain during or bleeding after vaginal sex.
• Ongoing pelvic or back pain without a known cause.

These symptoms may seem like other things, such as an infection. See your doctor if you have any of these symptoms.

Cervical cancer is usually found during a screening test. This may be an HPV test, HPV/Pap cotest, or Pap test. These tests check for high-risk types of HPV or cell changes that may be a sign of dysplasia or cancer. These tests can help find cervical cancer early, when it's easiest to treat. Get a screening test as often as your doctor suggests. In some cases, you may be able to collect your own HPV test sample.

If a screening test has an abnormal (or positive) result, a colposcopy may be done. This procedure uses a special tool to help the doctor look at the cells of the cervix. A colposcopy often includes taking a sample of the abnormal cells (biopsy). A biopsy is the only way to diagnose cervical cancer.

You and your doctor will discuss a treatment plan that's best for you. Options may include:

• Surgery. The part of the cervix with cancer may be removed. Or the whole cervix and the uterus may be removed (total hysterectomy).
• Radiation therapy. This treatment uses high-energy rays to kill cancer cells.
• Chemotherapy. This treatment uses strong medicine to kill cancer cells. It may be used along with radiation therapy.
• Targeted therapy. This treatment uses medicines (not chemotherapy) that attack and kill cancer cells. But it limits damage to healthy cells. Targeted therapy is not yet used as a first treatment for cervical cancer. But it may be used if it comes back or spreads.
• Immunotherapy. This treatment uses medicines to help the body's immune system attack cancer cells. Tests are done to see which immunotherapy medicines may work best for you.