- Cervical cancer
What is cervical cancer?
Cervical cancer begins when abnormal cells in the lining of the cervix grow uncontrollably.
Cancer most commonly starts in the area of the cervix called the transformation zone, but it may spread to tissues around the cervix, such as the vagina, or to other parts of the body, such as the lymph nodes, lungs or liver.
Learn more about:
- The cervix
- Types of cervical cancer
- Who gets cervical cancer?
- What causes cervical cancer?
- National HPV vaccination program
- What are the risk factors?
The cervix is part of the female reproductive system, which also includes the fallopian tubes, uterus (womb), ovaries, vagina (birth canal) and vulva (external genitals).
Also called the neck of the uterus, the cervix connects the uterus to the vagina. The cervix:
- produces moisture to lubricate the vagina, which keeps the vagina healthy
- opens to let menstrual blood pass from the uterus into the vagina
- produces mucus that helps sperm travel up the uterus and fallopian tubes to fertilise an egg that has been released from the ovary
- holds a developing baby in the uterus during pregnancy by remaining closed, then widens to let a baby be born through the vagina.
The cervix has an outer surface that opens into the vagina (ectocervix) and an inner surface that lines the cervical canal (endocervix). These two surfaces are covered by two types of cells:
Squamous cells – flat, thin cells that cover the outer surface of the cervix (ectocervix). Cancer of the squamous cells is called squamous cell carcinoma.
Glandular cells – column-shaped cells that cover the inner surface of the cervix (cervical canal or endocervix). Cancer of the glandular cells is called adenocarcinoma.
The female reproductive system
There are two main types of cervical cancer, which are named after the cells they start in:
Adenocarcinoma – a less common type (about 25% of cases), starts in the glandular cells of the cervix. Adenocarcinoma is more difficult to diagnose because it occurs higher up in the cervix and the abnormal glandular cells are harder to find.
A small number of cervical cancers feature both squamous cells and glandular cells. These cancers are known as adenosquamous carcinomas or mixed carcinomas.
Other rarer types of cancer that can start in the cervix include small cell carcinoma and cervical sarcoma.
Who gets cervical cancer?
About 850 women in Australia are diagnosed with cervical cancer every year. Cervical cancer is most commonly diagnosed in women over 30, but it can occur at any age. About one in 195 women will develop cervical cancer before the age of 75.
What causes cervical cancer?
Almost all cases of cervical cancer are caused by an infection called human papillomavirus (HPV). There are also other known risk factors.
Infection with HPV
HPV is the name for a group of viruses. It is a common infection that affects the surface of different areas of the body, such as the cervix, vagina and skin.
There are more than 100 different types of HPV, including over 40 types that affect the genitals. Genital HPV is usually spread via the skin during sexual contact. About four out of five people will become infected with at least one type of genital HPV at some time in their lives. Some other types of HPV cause common warts on the hands and feet.
Most people will not know they have HPV as it is usually harmless and doesn’t cause symptoms. In most people, the virus is cleared quickly by the immune system and no treatment is needed. In some women, the infection doesn’t go away and they have an increased risk of developing changes in the cervix. These changes usually develop slowly over many years.
Approximately 15 types of genital HPV cause cervical cancer. Screening tests are used to detect most of these types of HPV or the precancerous cell changes caused by the virus. There is also a vaccine that protects people from some types of HPV.
National HPV vaccination programThe HPV vaccine used in Australia protects against nine strains of HPV known to cause around 90% of cervical cancers.The vaccine also offers some protection against other less common cancers associated with HPV, including vaginal, vulvar, anal and oropharyngeal cancers.As part of the national HPV vaccination program, the vaccine is free for girls and boys aged 12–13. (The vaccine helps to protect males against penile, anal and oropharyngeal cancers.)People who are already sexually active may still benefit from the HPV vaccine. Ask your GP for more information.The HPV vaccine does not treat precancerous cell changes or cervical cancer.If you’ve been vaccinated, you will still need regular screening tests as the HPV vaccine does not provide protection against all types of HPV.For more information, visit hpvvaccine.org.au.
What are the risk factors?
Smoking and passive smoking
Chemicals in tobacco can damage the cells of the cervix, making cancer more likely to develop in women with HPV.
Long-term use of oral contraceptive (the pill)
Research has shown that women who have taken the pill for five years or more are at increased risk of developing cervical cancer. The reason for this is not clear. However, the risk is small and the pill can also help protect against other types of cancer, such as uterine and ovarian cancers. Talk to your doctor if you are concerned.
Having a weakened immune system
The immune system helps rid the body of HPV. Women with a weakened immune system have an increased risk of developing cervical cancer and need to have more frequent cervical screening tests. This includes women with the human immunodeficiency virus (HIV) and women who take medicines that lower their immunity. Ask your doctor if this applies to you and how often you should have a screening test.
Exposure to diethylstilbestrol (DES)
This is a synthetic (artificial) form of the female hormone oestrogen. DES was prescribed to pregnant women from the 1940s to the early 1970s to prevent miscarriage. Studies have shown that the daughters of women who took DES have a small but increased risk of developing a rare type of cervical adenocarcinoma.
A/Prof Penny Blomfield, Gynaecological Oncologist, Hobart Women’s Specialists, and Chair, Australian Society of Gynaecological Oncologists, TAS; Karina Campbell, Consumer; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Dr Pearly Khaw, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland; Prof Martin K Oehler, Director, Gynaecological Oncology, Royal Adelaide Hospital, SA; Dr Megan Smith, Program Manager – Cervix, Cancer Council NSW; Pauline Tanner, Cancer Nurse Coordinator – Gynaecology, WA Cancer & Palliative Care Network, WA; Tamara Wraith, Senior Clinician, Physiotherapy Department, The Royal Women’s Hospital, VIC. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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