According to the World Health Organization (WHO), in 2020 an estimated 604,000 women were diagnosed with cervical cancer worldwide, and about 342,000 women died from the disease. To honor Cervical Health Awareness Month, which is held in January, we give a short update on diagnosis and prevention of cervical cancer.
Cervical Cancer Screening
Cervical cancer probably affects 8–10 women per 100,000 every year. In developed countries, approximately 60% of women who are newly diagnosed with cervical cancer have either never been screened or not been screened in the previous 5 years. In the UK, a woman is recommended to have their first screening at 25 years old and then have them every three years. The most common form of screening is a conventional Pap smear or smear test, in which a spatula is inserted into the cervix to take a sample of cells. It is important to note that the smear is a test to help prevent cancer, not to detect it.
Post-Cervical Cancer Screening
Cervical cancer is associated with the HPV (human papillomavirus) group of viruses. If the sample of cells collected in the smear test is found to contain certain types of HPV, then it is checked to see if there are any changes in these cells. If the cells are abnormal then a colposcopy is needed to take a closer look at the cervix and to take a biopsy from any lesions detected. The results of the colposcopy will determine the next steps and what type of treatment and/or surgery the person should have.
There are risk factors that can affect the persistence and progression of HPV infections, which can lead to cancer in a woman’s cervix.
Risk factors include:
- Diet: a lack of folic acid in the blood has been reported to enhance the effects of other risk factors, such as smoking.
- Age: HPV is more commonly found in adolescents. However, due to the HPV vaccines (see below) research has predicted that this is likely to change to people who are middle-aged and older.
- Smoking: causes a weakened immune system and can damage cells, making cancer more likely to develop.
- Pregnancy and childbirth.
- Oral contraceptives: for women who have taken ”the pill” for five years or more, there is an increased risk of developing cervical cancer. However, this risk appears to be small and often the benefits of taking the pill exceed the risks.
- Multiple sexual partners: there is an increased chance of developing certain HPV types if someone has had more than three sexual partners. However, most people have had three or more sexual partners in their lifetime, so it is nothing to be ashamed or overly worried about.
- A weakened immune system.
The three licensed HPV vaccines are administered to adolescents in order to prevent infection and consequent disease from certain types of HPV. These give effective protection against cervical cancer developing from these HPV types. However, it is important to note that the vaccines do not replace the need for cervical screening and do not prevent cancer from developing from all HPV types.
If you want to know more about the smear test you can read the corresponding article here, or if you have any questions make an appointment to consult your doctor, gynecologist or local GP.
The information of this article is based on “Fast Facts: Gynecologic Oncology” by Shohreh Shahabi, Richard J. Smith and Giuseppe Del Priore. This publication for health care professionals looks at the use and benefits of regular screening, the risk factors that can increase chances of developing cervical cancer and the methods used to prevent and decrease these risks. The digital version of the book is freely available here.