Reviewed by: Zhu Jianqing (Zhejiang Cancer Hospital)
Author: National Cancer Institute (NCI)
Cervical cancer is a disease in which malignant tumors (cancers) form in the cervix.
1. Bring you to know cervical cancer
The female reproductive system includes the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus is made up of the muscle layer and endometrium, and the cervix is a narrow part of the lower part of the uterus (the hollow pear-shaped organ that grows in the fetus) that connects the uterus to the vagina (the birth canal).
Cervical cancer usually develops slowly. Before the cervix becomes cancerous, cervical cell hyperplasia occurs first, that is, abnormal cells appear in the cervical tissue. Over time, these abnormal cells can become cancerous, growing deep into the cervix and spreading to the surrounding area.
Image source: Stand Cool Helo
2. Risk factors for cervical cancer
Human papillomavirus (HPV) infection is a major risk factor for cervical cancer. All factors that increase the risk of developing the disease are referred to as risk factors. However, having risk factors does not mean that you will develop cancer, and no risk factor does not mean that you will not develop cancer.
HPV infection is the most common cause of cervical cancer, but not all HPV-infected women develop cervical cancer. Among them, women who do not have regular HPV or cervical cytology screening have an increased risk of developing cervical cancer. In people who are not infected with HPV, there are three vaccines available to prevent HPV infection.
In addition, other risk factors for cervical cancer include:
Multiple births;
There are many companions;
The first time married life begins earlier;
smoking.
3. What are the symptoms of cervical cancer?
Early-stage cervical cancer usually has no signs or symptoms. Women should have regular check-ups, including HPV testing or cervical cytology. If the cancer is detected early, the prognosis is better.
Signs and symptoms of cervical cancer include vaginal bleeding and pelvic pain. But in addition to this, other diseases can also cause these symptoms. Consult your doctor if:
Vaginal bleeding (including bleeding after the couple's life): This is the most common symptom.
Abnormal vaginal discharge, shedding necrotic tumors.
Pelvic pain.
Couples live in pain.
4. What tests can be used to diagnose cervical cancer?
Cervical examination can be used to detect and diagnose cervical cancer. There are mainly the following test methods:
Physical examination and history asked
Physical examination is used to look at a patient's overall health, including checking for signs of disease, such as lumps and other abnormalities. In addition, the doctor will ask about the patient's medical history as well as the history of treatment.
Pelvic examination
Examination of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse will wear gloves, apply lubrication to the gloves, insert 1 or 2 fingers into the vagina, and hold down the lower abdomen with the other hand to probe the size, shape, and location of the uterus and ovaries, and then insert a voyeurometer into the vagina to check the vagina and cervix for signs of disease. At the same time, a pap smear is usually done. In addition, the doctor or nurse will also examine the rectum to detect lumps or abnormal areas.
Cervical cytology
Cervical cytology is a test that collects cells from the surface of the cervix and vagina. The doctor inserts a peepire into the vagina, keeps the vagina open, gently scrapes the cells from the cervix and vaginal surface using a cotton swab, brush or small wooden stick, and looks under a microscope for abnormalities.
5. Human papillomavirus (HPV) testing
This is a laboratory test used to detect DNA (deoxyribonucleic acid) or RNA (ribonucleic acid) or RNA (ribonucleic acid) for specific types of HPV infection. Cells collected from the cervix and THE DNA or RNA in the cells are examined for HPV infection associated with cervical cancer. HPV testing can be performed using a sample of cells examined on a cervical smear. HPV testing may also be done if cervical cytology reveals specific cervical abnormalities.
Colposcopy
A test that uses a colposcope (a magnifying device with a light source) to check the vagina and cervix for abnormalities. Tissue samples are usually taken with a spatula and then examined under a microscope for lesions.
Cervical biopsy
If abnormal cells are found on the cervical smear, doctors may perform a biopsy. A sample of tissue is excised from the cervix and then examined by a pathologist under a microscope. For a biopsy that removes only a small amount of tissue, usually done in the clinic, if a pyramidal cervical biopsy is to be performed (i.e., a larger cone of cervical tissue is removed), the patient may need to be hospitalized.
6. What is the treatment and prognosis of cervical cancer?
In general, certain factors can affect the prognosis of cervical cancer and the choice of treatment options.
The prognosis of cervical cancer mainly depends on the following aspects:
Stage of cancer: size of the tumor, involvement of part of the cervix or the entire cervix, and whether it has spread to lymph nodes or other parts of the body.
Types of cervical cancer.
Age and physical health of the patient.
Whether the patient is infected with a specific type of human papillomavirus (HPV).
Whether the patient is infected with the human immunodeficiency virus (HIV).
The initial diagnosis is still a recurrence.
Overall, the prognosis of cervical cancer is relatively good among all cancers. According to the American Cancer Society in 2010, the 5-year survival rate for stage I cervical cancer is 80% to 93%, stage II is 58% to 63%, stage III is 32% to 35%, and stage IV is 15% to 16%.
7. Choice of treatment plan
It mainly depends on the following aspects:
Staging of cancer;
Types of cervical cancer;
Whether the patient has a birth plan;
Patient age.
Treatments for cervical cancer include surgery, radiation therapy, and chemotherapy, which are selected according to the stage, with surgery in the early stages, radiation therapy in the middle and advanced stages, and sometimes chemotherapy.
In addition, the regimen for the treatment of cervical cancer in patients during pregnancy depends on the stage of cancer and the stage of pregnancy, and for early cervical cancer or cancer detected at the end of pregnancy, treatment can be postponed until after delivery.
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