What should I know about cervical cancer?

Cervical cancer starts in the cells that line the cervix. The cervix is the lower portion of a women's uterus (also called the womb). It connects the uterus to the vagina and plays an important role during childbirth.

Before cervical cancer develops, the cells of the cervix start to change and become abnormal. These abnormal changes are precancerous, which means they are not cancer, but may, with time, become cancer. Precancerous changes to the cervix are called dysplasia of the cervix (or cervical dysplasia).

Precancerous conditions are quite common and can be easily treated if found early. That's why it's important to have regular pap tests and pelvic exams and talk about your risk factors with your doctor.

What are the risk factors for cervical cancer?

The main risk factor for developing cervical cancer is the sexually transmitted human papilloma virus (HPV) that infects the cervix. HPV is a group of more than 100 types of viruses. Some types of HPV can be passed easily from person to person through sexual contact. HPV infections are common and usually go away without treatment because the immune system gets rid of the virus. However, certain types of sexually transmitted HPV can cause changes to cells in the cervix that may lead to cervical cancer.

The HPV vaccine approved for use in Canada to prevent HPV infection should be viewed as a complement, not a replacement, for cervical cancer screening.

Other risk factors for developing cervical cancer include:

• Becoming sexually active at a young age; having many sexual partners, or having a sexual partner that has had many sexual partners.
• Smoking.
• An immune system weakened from taking drugs following a transplant, or having a disease such as AIDS.
• The use of birth control pills for a long period of time.
• Giving birth to many children.
• Having taken diethylstilbestrol (DES), or being the daughter of a mother who took DES.

Are there screening tests for this type of cancer?

If you are sexually active you should have a Pap test and pelvic examination every 1 to 3 years depending on the screening guidelines in your province. If you have had a hysterectomy, you may still need a Pap test, but talk to your doctor about whether this is necessary. Even if you have stopped having sex, you should continue to have a Pap test.

What are the signs and symptoms?

Cervical cancer can develop over a long time without causing any signs or symptoms. Changes to the cervix are often discovered during your regular Pap test.

Having the following signs and symptoms does not necessarily mean that you have cervical cancer. They could be caused by other problems, so see your doctor to be sure:

• abnormal bleeding from the vagina
  • bleeding or spotting between regular menstrual periods
  • bleeding after sex
  • menstrual periods that last longer and are heavier than before
  • bleeding after menopause
• more discharge from the vagina than normal
• pain in the pelvis or lower back
• pain during sexual intercourse

Additional resources

• Canadian Partnership Against Cancer
• Canadian Cancer Society
• Society of Gynecologic Oncologists of Canada
• Cancer Care Ontario
• National Cancer Institute
• Centers for Disease Control and Prevention
• International Agency for Research on Cancer
• The Cochrane Collaboration

Prepared by the Canadian Cancer Society. This information appeared originally on the Canadian Health Network Web site.