Thanks to major treatment advances, doctors can now prevent and treat cervical cancer more effectively.
Each year, about 13,000 women in the United States are diagnosed with cervical cancer. In the past 40 years, the number of cases of cervical cancer has decreased greatly. This is largely because more women are regularly screened with Pap tests. Improved screening methods have made it easier for doctors to find abnormal cells that can become cancerous, as well as cells that are already cancerous.
There are two main types of cervical cancer. The most common is squamous cell carcinoma, which makes up about 80 to 90 percent of all cervical cancers. The other is adenocarcinoma, which makes up 10 to 20 percent of all cervical cancers.
Cervical cancer almost always is caused by human papillomavirus (HPV) infection. Many adults have been infected with HPV at some time in their lives, but most infections clear up on their own. An HPV infection that does not go away can result in cervical cancer in some women who do not receive regular screening. However, most women infected with HPV do not develop cancer.
If a Pap test shows abnormal precancerous cells, the doctor also may recommend an HPV test to detect the virus. Precancerous cells look different from normal cells but have not yet become cancerous.
Factors that increase the risk of cervical cancer include smoking and an immune system that may be weakened by infection with HIV (the human immunodeficiency virus), for example. A common bacteria called chlamydia, which can infect the reproductive system through sexual contact, may increase the risk of cervical cancer.
There also is evidence that long-term use of birth control pills increases the risk of cervical cancer. The risk goes down after use of the pills is stopped.
Cervical cancer usually is slow-growing and may not show any symptoms. The Pap test can find abnormal cells before they become cancerous.
During a pelvic exam, the doctor gently scrapes cells from the cervix, which are then looked at under a microscope. If unusual cells are found, the doctor may order HPV testing. If that test shows the presence of high-risk strains of HPV, the doctor will perform a colposcopy to look more closely at the cervix.
A colposcopy also may be done if the cells in the cervix appear to be abnormal (cervical neoplasia). The colposcope combines a bright light with a magnifying lens to make it easier to see the tissue. If there are abnormal cells in the cervix, the doctor will take a tissue sample (biopsy). Most of the time, this type of biopsy is performed in the doctor’s office, usually under local anesthesia.
When found early, cervical cancer can be treated effectively. Precancerous cells usually can be removed without harming healthy cells. If the abnormal cells have become cancerous, the most common treatments are surgery, radiation and chemotherapy.
Radiation alone or surgery to remove part or all of the cervix may be used for a small tumor or early-stage cervical cancer. A combination of chemotherapy and radiation often is used for large tumors or more advanced cervical cancers. Choosing the best treatment also takes into account a woman’s desire to have children. Some treatments can preserve fertility for future successful pregnancies.
A gynecologic oncologist—a doctor specializing in cancers of the female reproductive system, including the cervix, uterus (womb) and ovaries—should head the health care team for the best possible outcome.
Several types of surgery may be used to treat cervical cancer or remove precancerous cells from the cervix:
Cryosurgery. Used to treat precancer of the cervix. Liquid nitrogen is used to freeze the abnormal cells and destroy them.
Laser surgery. Also used to treat precancer of the cervix. A focused laser beam is used to remove abnormal cells. This can be done in a doctor’s office under local anesthesia.
LEEP (loop electrocautery excision procedure)/LLETZ (large loop excision of the transformation zone). Used to remove an abnormal area on the cervix seen during colposcopy. If there are abnormal cell