Cervical cancer begins when abnormal cells in the lining of the cervix grow uncontrollably. Cancer often starts in the transformation zone. It may then spread to tissues around the cervix, such as the vagina, parametrium (tissue surrounding the cervix) or to other parts of the body, such as the lymph nodes, lungs or liver.
Learn more about:
The cervix
The cervix is part of the female reproductive system, which also includes the ovaries, fallopian tubes, uterus (womb), vagina (birth canal) and vulva (external genitals).
The cervix, sometimes called the neck of the uterus, connects the uterus to the vagina. It helps keep the vagina healthy, lets menstrual blood flow out (your period), and makes mucus that can help sperm reach an egg. During pregnancy, it stays closed, opening when it’s time for the baby to be born.
The cervix has 2 types of cells:
- Squamous cells – flat, thin cells that cover the outer surface of the cervix (ectocervix)
- Glandular cells – column-shaped cells that cover the inner surface of the cervix (cervical canal or endocervix).
The area where the squamous cells and glandular cells meet is known as the transformation zone.
The female reproductive system
Types of cervical cancer
There are 2 types of cervical cancer that make up most of all cervical cancers.
These are:
- squamous cell carcinoma (SCC) – the most common type (about 60% of cases), starts in the squamous cells of the cervix
- adenocarcinoma – starts in the glandular cells of the cervix (almost 30% of cases).
A small number of cervical cancers (less than 1 in 20) feature both squamous cells and glandular cells. These cancers are known as adenosquamous carcinomas or mixed carcinomas.
There are other rarer types of cancer that can start in the cervix. These include small cell cervical carcinoma, cervical clear cell adenocarcinoma and cervical sarcoma.
Who gets cervical cancer?
Anyone with a cervix can get cervical cancer – women, transgender men and people with an intersex variation. Each year in Australia, fewer than 1000 people are diagnosed with cervical cancer.
Cervical cancer is most commonly diagnosed in people over the age of 30. More than half of all cervical cancer cases are diagnosed in those aged 30–49 years, but it can occur at any age.
Cervical cancer has become much less common in Australia since the National Cervical Screening Program started in 1991. The program uses screening tests to look for early changes to the cells in the cervix that are not cancer but, if left untreated, may turn into cancer.
A national human papillomavirus (HPV) vaccination program was introduced in 2007, and this is expected to continue to reduce the number of new cervical cancer cases.
What causes cervical cancer?
Almost all cases of cervical cancer are caused by an infection with the human papillomavirus (HPV). This virus can affect the surface of different areas of the body, such as the cervix, vagina, vulva, throat and skin. Read more about other known risk factors.
Infection with HPV
There are more than 100 different types of HPV, including over 40 types that can infect the genitals and 14 that are known to cause cervical cancer.
About 4 out of 5 people will become infected with at least one type of genital HPV at some point in their lifetime. Most people will not know they have HPV because it often doesn’t cause symptoms and usually clears quickly.
Genital HPV is usually spread during close contact with genital skin during sexual activity. This includes penetrative sex, oral sex and other forms of sexual activity (e.g. using sex toys). Using condoms or dental dams can offer some protection against HPV.
The cervical screening test is used to detect cancer-causing types of HPV, as well as any precancerous cell changes caused by the virus. There is also a vaccine that protects people from some types of HPV (see below).
National HPV vaccination program
This vaccination can prevent infection with HPV. The most common HPV vaccine used in Australia protects against 7 high-risk types of HPV known to cause about 90% of cervical cancers. The vaccine also offers some protection against less common cancers linked with HPV, including vaginal, vulvar, anal and some head and neck cancers.
Free vaccines are provided at school for all children aged 12–13, under the national HPV vaccination program. People who were not vaccinated at school can receive it for free from their health care provider or pharmacy until the age of 25. People aged 26 and over who have not been vaccinated can ask their doctor if they may benefit from having the vaccine.
Even if you’ve had the HPV vaccine, you still need regular screening tests. The vaccine doesn’t protect against all types of HPV. For information, visit hpvvaccine.org.au.
What are the other risk factors?
Other factors that may increase the risk of developing cervical cancer include:
- smoking and passive smoking – chemicals in tobacco can damage the cells of the cervix, making it harder for the body to clear the HPV infection
- using oral contraceptives (the pill) for a long time – some research has suggested that taking the pill for 5 years or more slightly increases the risk of developing cervical cancer in people with HPV
- having a weakened immune system – this includes people who have had an organ transplant as well as those with human immunodeficiency virus (HIV).
Australia is predicted to eliminate cervical cancer by 2035. This is largely due to the national human papillomavirus (HPV) vaccination program. HPV causes almost all cases of cervical cancer. Cervical cancer will be considered eliminated in Australia when there are fewer than 4 new cases per 100,000 people a year.
→ READ MORE: Cervical cancer symptoms
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Dr Antonia Jones, Gynaecological Oncologist, Royal Women’s Hospital and Mercy Hospital for Women, Melbourne, VIC; Angelyn Aligarbes, Consumer; A/Prof Emma Allanson, Gynaecological Oncologist and Head of Dept, Gynaecologic Oncology, King Edward Memorial Hospital for Women, WA; Gemma Busuttil, Radiation Therapist Specialist, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW; Laura Carman, 13 11 20 Consultant, Cancer Council VIC; Danielle Carpenter, Gynaecology Nurse Consultant, Peter MacCallum Cancer Centre, VIC; A/Prof Pearly Khaw, Lead Radiation Oncologist – Gynae-Oncology, Peter MacCallum Cancer Centre, VIC; Georgina Richter, Gynae-Oncology Clinical Nurse Consultant, Royal Adelaide Hospital, SA; A/Prof Megan Smith, Research Fellow, Cancer Elimination Collaboration, University of Sydney, NSW; Sophia Wooldridge, Senior Clinical Psychologist, Hunter New England Centre for Gynaecological Cancer, John Hunter Hospital, NSW; Melissa Whalen, Consumer.
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