Cervical cancer is uncontrolled multiplication of cells in a woman’s cervix. The cervix includes the lower portion and opening of the uterus, the hollow, muscular organ in which a baby develops. Throughout the world, cancer of the cervix is an extremely common cancer of the female reproductive system. But it is a cancer that can be diagnosed and cured in its early stages.
Cervical cancer arises in cells of the epithelium << `ehp` uh THEE lee uhm >>, a type of tissue that covers the cervix. The first phase of the disease is called cervical intraepithelial neoplasia << SUR vuh kuhl `ihn` truh `ehp` uh THEE lee uhl `nee` oh PLAY zhuh >> and often abbreviated CIN. In CIN, cells of the epithelium look abnormal under a microscope but have not yet become cancerous.
Untreated CIN may progress to a phase known as preinvasive. The progression usually occurs over 5 to 10 years but may take less than a year. Preinvasive neoplasia has not yet spread from the epithelium into deeper tissues of the cervix. The preinvasive phase may then progress to invasive cancer. Invasive cancer extends into layers of cervical tissue beneath the epithelium. In the most advanced cases, it reaches other organs or even distant parts of the body.
A simple, painless office procedure called a Pap test can detect all stages of cervical cell abnormalities. For a complete description of this procedure, see the Pap test article. If a Pap test reveals abnormalities, doctors usually examine the cervix with a type of microscope called a colposcope << KOL puh skohp >>. Tissue samples from suspicious areas provide a definite diagnosis.
Doctors can treat most cases of CIN or preinvasive neoplasia by removing only the affected cervical tissue. Removal methods include surgery, laser vaporization, and cryotherapy (freezing). Women with no future plans to have children may be treated with a hysterectomy (removal of the entire uterus).
In most cases, doctors can cure invasive cervical cancer with either a radical hysterectomy (surgery that removes the uterus and nearby lymph nodes) or with radiation. Radiation combined with chemotherapy (treatment with drugs) can also cure many tumors that extend to nearby organs. Cancer that has spread to distant parts of the body can rarely be cured but may be controlled for some time with chemotherapy.
The most common cause of cervical cancer is infection with human papilloma virus (HPV). This virus is transmitted during sexual intercourse. Smoking cigarettes or inhaling second-hand smoke increases the risk of infection. Having sex during early adolescence also increases risk, because the cervical epithelium is more easily infected in young women. Having sex with multiple partners raises risk, as does having sex with one partner who has had many other partners. In 2006, the United States Food and Drug Administration (FDA) approved a vaccine that is highly effective against HPV and which may be used to prevent cervical cancer caused by the virus.
See also Human papillomavirus.
