Cervical cancer develops through pre-cancerous stages (cervical dysplasia, CIN) over many years. The introduction of the PAP smear screening has reduced the incidence of cervical cancer dramatically in countries of the developed world. It is also called cancer of the uterine cervix. The cervix is part of the female reproductive system, which also includes the uterus, ovaries, fallopian tubes, vagina and vulva. The cervix is the lower part of the uterus that connects to the vagina.

Estimated 2017 cases in Australia

  • Cervical cancer is estimated to be the 14th most commonly diagnosed cancer among females and the third most commonly diagnosed gynaecological cancer in Australian women;
  • 912 females diagnosed with cervical cancer in 2017 ie. 1.5% of all new female cases of cancer diagnosed;
  • 254 female deaths from cervical cancer in 2017 which is 1.2% of all females deaths from cancer;
  • 72% of patients with cervical cancer survive the 5 year mark. 

Known risk factors

Risk factors for cervical cancer are:

  • infection with human papillomavirus (HPV), a virus transmitted by sexual activity
  • smoking
  • lack of regular Pap tests
  • age
  • taking contraceptive pills for a long time
  • previous abnormality or cancer of the cervix
  • having many children
  • diethylstilboestrol (DES).

Symptoms

Changes to cervical cells do not usually cause any symptoms – this is why regular Pap tests are so important.

If cervical cell changes develop into cervical cancer, the most common symptoms include:

  • vaginal bleeding between periods
  • vaginal bleeding after menopause
  • bleeding after sex
  • pain during sex
  • unusual vaginal discharge.

Advanced cervical cancer is very uncommon, but it may cause:

  • extreme tiredness
  • leg pain or swelling
  • lower back pain.

Many conditions can cause these symptoms, not just cervical cancer. However, if you have unusual bleeding, discharge or pain, please see your doctor as soon as possible.

Prevention and screening

In addition to not smoking, there are two important ways of preventing cervical cancer: cervical cancer screening using the Pap test and human papillomavirus (HPV) vaccination.

Cervical Cancer Screening

The National Cervical Cancer Screening Program is changing. From 1 December 2017, the Pap test will be replaced with a new Cervical Screening Test. For more information, visit the Cancer Australia website.

Diagnosis and treatment

Treatment depends on the stage of disease. Very early cervical cancer (microinvasive) can be treated by a cone biopsy or a simple hysterectomy. Patients with cervical cancer limited to the uterine cervix require a radical hysterectomy, at which a safety margin around the cancer is taken. These patients also require removal of lymph nodes along the large blood vessels in the pelvis. Patients with advanced disease (stage 2+) require a combination of chemotherapy (weekly) plus radiotherapy (daily) for four to six weeks. Survival depends on the stage of disease with more than 75% of patients surviving stage 1.

Detailed information about diagnosis testing and treatment options can be found on the Cancer Australia website.

Source: Cancer Australia 2017