To mark the start of cervical cancer awareness week, we've asked the experts to simplify everything you need to know, from risk factors to prevention.
It's form of cancer that develops in a woman's cervix, the entrance to the womb from the vagina.
HuffPost UK Lifestyle spoke to Adeola Olaitan, consultant gynaecological oncologist at the University College London and expert at The Eve Appeal, Martin Ledwick, Cancer Research UK’s head information nurse and Robert Music, chief executive of Jo’s Cervical Cancer Trust, to find out more about symptoms, causes and prevention.
The human papilloma virus (HPV) is the main cause of cervical cancer. It is estimated, according to JMM Walboomers writing in the Journal of Pathology, to cause as many as 99.7% of cases.
HPV is a sexually transmitted disease which comes in more than 100 different forms. Some are symptomless, while others can cause genital warts or verrucas.
According to Martin around 15 strands are linked to cervical cancer, with two particular types (HPV 16 and 18) causing approximately 70% of cervical cancers alone.
"Around 80% of people would have been infected as some stage in their lives," says Adeola.
"The virus is normally cleared by the body's immune system and the majority of people get rid of it within 2 years. A small proportion of women will have persistent infection for reasons we do not fully understand. We do know however that women with an impaired immune system are ore likely to have persistent infection."
Despite often having no clear indicators, the virus can be spotted during routine cervical smear tests. So it is important to attend these regularly.
It could take as many as 10 to 20 years for cervical cancer to develop after a HPV infection, says Martin. But he stresses the importance of catching the virus as soon as possible.
HPV isn't the only cause of cervical cancer however. Robert notes many other potential causes, including: smoking, weakened immune system, having children at a very young age, giving birth to many children and long-term use of the contraceptive pill - this can slightly increase the risk of developing cervical cancer but the benefits of the pill outweigh the risks for most women.
QUESTIONS YOU MAY HAVE AROUND CERVICAL CANCER:
- Cervical Screening is not a diagnostic test for cancer; it is designed to identify abnormal cells that may one day lead to cancer. 1 in 14 women over 25 yrs, and 1 in 3 under the age of 25, have ‘abnormal’ smears.
- To determine if there is indeed an abnormality, women will then have to have further tests which might involve a large biopsy of the cervix potentially leading to cervical incompetence. A lot of women under 25 would have to undergo these procedures to detect one with true abnormalities.
- There has been no increase in mortality from cervical cancer in under 25s since the screening age was raised in 2003. The Office for National Statistics showed that in 2010 only 45 women aged between 20–24 years were diagnosed with cervical cancer.
- The UK National Screening Committee (UKNSC) has announced that it’s set to introduce a blanket screening policy, which will raise the age to 25 everywhere to bring Scotland and Wales in line with England and Northern Ireland.
- It is important that young women (and indeed women of all ages) are aware of the symptoms of cervical cancer so that if they are at all concerned they can go to their GP to arrange a referral to a specialist for a diagnosis.
Source: The Eve Appeal
What happens if you have HPV?
"We cannot treat HPV infection, we can only treat the cell changes that it sometimes produces," says Adeola.
"Women only get screened for HPV as part of cervical screening. If a woman attends for screening and has a normal result, she will not be screened for HPV. If the test shows a mildly abnormal result then the woman is tested for HPV on the same sample.In other words she will not need to be called back for another test.
"If she is negative for HPV, the mild smear abnormality is considered insignificant and she will be advised to have routine screening. If the HPV test is positive, she will be referred to a specialist for a test called colposcopy where the cervix is examined with a magnifying device to exclude a higher grade abnormality. So HPV testing is used to decide which women will benefit from further investigations."
There are usually no symptoms with abnormal cells (in their pre-cancerous state) and sometimes none with early stage cervical cancer either.
Some recognised symptoms to look out for include:
- Abnormal bleeding: after or during sexual intercourse, or between periods
- Post menopausal bleeding, if you are not on HRT or have stopped it for six weeks
- Unusual and/or unpleasant vaginal discharge
- Discomfort or pain during sex
- Lower back pain
Of course with lack of symptoms not unheard of, both Martin and Robert stress the importance of attending routine cervical smear test.
"Screening allows any abnormal cell changes to be picked up before they can develop into cancer," says Martin. "It’s estimated that cervical screening saves around 5000 lives each year in the UK and, since its introduction in the 1980s, rates of the disease have almost halved."
"Cervical cancer is unusual in being theoretically totally preventable by screening, because early changes in the cells of the cervix can be picked up long before a cancer will ever develop," says Robert.
"Nowadays girls aged 12 or 13 in the UK are routinely offered the HPV vaccine at school," Martin adds. "These vaccines protect against the types of HPV that are most likely to cause cervical cancer. But they do not protect against all strains."
"Treatment of cervical cancer depends on the stage at which it is detected and, to some extent, whether or not the patient wishes to try and conserve fertility," says Adeola.
"Very early cervical cancer can be treated with a cone biopsy, a procedure that removes a small part of the cervix, leaving the womb intact so the woman can have children. If she has completed her family, the woman might opt for a hysterectomy. If the disease is slightly more advanced but still confined to the cervix, the treatment is a radical hysterectomy which is an operation to remove the womb and the tissue around the womb.
"In addition, the lymph glands in the pelvis are removed. The ovaries may be left behind in a younger patient so that she does not go through the menopause. Larger cancers are treated with a combination of radiotherapy and chemotherapy. The earlier a cancer is detected, the higher the chances of cure. It is important therefore that women do not ignore symptoms that might suggest cervical cancer."
For more information visit:
The Eve Appeal or call their helpline on 020 7605 0100.
Jo's Cervical Cancer Trust or call their helpline on 0808 802 8000.
Cancer Research UK or call their team of specialist nurses on 0808 800 4040.
Also on HuffPost:
The founder of Liz Lange Maternity is now a <a href="http://www.huffingtonpost.com/liz-lange/cervical-cancer-the-silent-killer-of-women-in-the-developing-world_b_1655231.html">vocal spokesperson for cervical cancer awareness</a> after her own 2001 diagnosis. <a href="http://www.health.com/health/article/0,,20411629,00.html">"The diagnosis terrified me,"</a> she told Health.com: <blockquote>I had a 2-and-a-half-year-old and an 8-month-old baby, and I was working on a fashion show and launching a new product line. On a personal level, I was afraid that I wouldn’t be there for my children; professionally, I was afraid that if people knew about my diagnosis, they would think of me as sick and be uncomfortable doing business with my company. It was so upsetting that any time I talked about it I burst into tears. I kept silent about it for a long time."</blockquote> After a hysterectomy, chemotherapy and radiation, Lange has been cancer-free. "Now I feel absolutely compelled to tell my story, because it really shows how it can happen to anyone," she told the website.
The actress reportedly <a href="http://newsone.com/2015287/yvette-wilson-cancer/">faced mounting medical bills</a> for both cervical cancer and kidney disease before ultimately <a href="http://www.huffingtonpost.com/2012/06/15/yvette-wilson-star-of-moe_n_1600037.html">losing her battle with stage 4 cervical cancer in 2012</a>. African-American women are <a href="http://www.cdc.gov/cancer/cervical/statistics/race.htm">most likely to die from the disease</a>, compared to women of other races and ethnicities, according to 2008 data from the CDC, possibly because black women seem to have <a href="http://www.huffingtonpost.com/2012/06/15/yvette-wilson-star-of-moe_n_1600037.html">more trouble clearing HPV</a>, which usually goes away on its own within a year or so.
In 2012, the beloved author shared in a blog post that she had recently been <a href="http://www.people.com/people/article/0,,20627052,00.html">diagnosed with breast cancer</a>. But, deeper into her post, she also revealed she had a hysterectomy 17 years earlier because of cervical cancer (caused by HPV). "No other treatment necessary," she wrote on her blog: <blockquote>Another story for another time. If I had a young daughter or son I'd talk to their docs about having the vaccine to protect them from getting or giving HPV. If only there was a vaccine to protect us from breast cancer we'd be lined up -- wouldn't we?</blockquote>
In 2001, the actress was <a href="http://www.people.com/people/article/0,,20196314,00.html">diagnosed with cervical cancer</a> after a Pap test, People reported. She opted for a hysterectomy, but doctors were able to preserve her ovaries, allowing her to <a href="http://www.people.com/people/article/0,,20445749,00.html">welcome son Zev in 2008 via a surrogate</a>. "<a href="http://www.people.com/people/article/0,,20009915,00.html">I woke up after the surgery</a>, and I asked what they took out," she told People in 2007. <blockquote>They didn't know what they would find beforehand. But it was just my uterus. I had my ovaries, and I didn't have to go through chemo. I thought, "Okay, now the cancer is gone. Let's get going." My doctors gave me the all clear, and I moved to New York City in January 2002. It was the best time of my life.</blockquote>
The 27-year-old British reality TV star <a href="http://www.huffingtonpost.co.uk/2012/03/19/jade-goody-cervical-cancer-women-smear-tests_n_1361915.html">died from cervical cancer at the age of 27</a>, after publicly documenting her battle with the disease. Some questioned how the disease progressed in someone so young, and Goody admitted to <a href="http://news.health.com/2009/04/06/jade-goody-cervical-cancer/">ignoring doctors' urges for follow-up care</a>, Health.com reported. Still, her openness and honesty about treatment did raise awareness for prevention. Experts noted <a href="http://www.huffingtonpost.co.uk/2012/03/19/jade-goody-cervical-cancer-women-smear-tests_n_1361915.html">spikes in the number of young women making appointments for Pap tests</a> shortly after her death, HuffPost UK reported.
The former first lady of Argentina, more commonly known as Evita, was <a href="http://www.nytimes.com/2011/12/20/health/report-on-eva-peron-recalls-time-when-lobotomy-was-embraced.html">diagnosed with advanced cervical cancer</a> in August 1951, according to an essay in <em>The New York Times</em>. At the time, it was common to keep the patient in the dark about her true condition, so Peron was told she had a uterine problem and then operated on in secrecy. (The doctor entered the room only after she was under anesthesia.) Radiation and chemotherapy (and a lobotomy "for the pain") followed, but she grew sicker, until dying from the disease in 1952 at the age of 33.
This "Real Housewife" of Orange County appeared on an episode of the "Dr. Oz" show and <a href="http://www.people.com/people/article/0,,20585473,00.html">revealed she had been diagnosed with cervical cancer</a> in 2012. "I go to the doctor and I have lumps in my breasts and I had cervical cancer that had to be removed... <a href="http://www.bravotv.com/blogs/the-dish/tamra-barney-on-her-cervical-cancer-scareyvette">I'm talking to my doctor about... doing a hysterectomy</a>," she said.