Cervical Cancer


Overview

What is cervical cancer?

The cervix is the narrow lower portion of the uterus that opens into the vagina.

Cervical cancer is a disease in which malignant cancer cells form in the tissues of the cervix.

Human papillomavirus (HPV) causes almost all cases of cervical cancer, which is a common sexually transmitted infection.

There is a highly effective vaccine that prevents the majority of cervical cancers before they begin.

Estimates show that about 14 million new infections occur every year.

There are usually no signs or symptoms of early cervical cancer but it can be detected early with regular check-ups.

However, signs and symptoms include:

  • Bleeding after vaginal sex
  • Bleeding after menopause
  • bleeding after douching or a pelvic exam.
  • Spotting between periods,
  • Pain during sex
  • Menstrual periods that are longer or heavier than usual.

Cervical cancer takes years to develop and there is a pre-cancer stage that can be easily identified and treated.

PREVENTION

Screening

  • Vaccination against HPV is the best preventive measure to take against cervical cancer. For women who haven’t received the vaccination, Pap tests are the key means for preventing cervical cancer.
  • The Pap test, or smear, is one of the most reliable cancer-screening tests available. These tests can detect abnormal cells and precancerous changes on the cervix. Early detection allows these abnormal cells and changes to be treated before they develop into cancer.
  • Doctors may also do an HPV test the same time they do a pap test.

Vaccination

  • Vaccination against HPV is advised for prevention of of HPV infection, cervical cancer, as well as genital warts. It’s only effective when given to people before they become infected with the virus. This is why it’s recommended that you get it before you’re sexually active.
  • There are two vaccines currently available that protect against HPV, the virus that causes cervical cancer: Gardasil and Cerarix. Both Gardasil and Cevarix protect against HPV types 16 and 18, which together account for approximately 70% of all cervical cancer cases. Gardasil has also been shown to be effective in preventing some cancers in men caused by HPV.
  • Because men can carry HPV, and according to the CDC, preteen boys and girls should be vaccinated at age 11 or 12. Young women can get the vaccine through age 26 and young men through age 21 if they haven’t already been exposed to HPV.
  • Early detection and treatment of precancer have high success rates, yet nearly 270,000 women die from the disease each year.

Source: PAHO, Comprehensive Cervical Cancer Control       For additional information go to: CDC

SCREENING

HPV testing

The goal of HPV DNA testing is to detect the presence of genetic material from certain high-risk strains of the Human Papillomavirus (HPV) in cells from a woman’s cervix.

Nearly all cases of cervical cancer develop from persistent, untreated HPV infection, so HPV testing, linked with timely treatment, may be the most effective way to prevent cervical cancer.

HC2

It is used to test for the presence of HPV DNA. However, this test requires a full-scale laboratory and electricity, making it unsuitable for many low-resource settings.

For additional information go to: QIAGEN

CareHPV

Another HPV test, called careHPV, was developed by Qiagen with support from PATH and the Bill and Melinda Gates Foundation. CareHPV was designed specifically for use in low-resource settings. It is portable, rapid, and can be performed by a minimally trained health worker.

One of the benefits of HPV DNA testing is that women have the option of collecting their own sample and bypassing the traditional speculum exam, which many women find uncomfortable. Furthermore, because of the accuracy of the test, a woman who receives a negative test result will not have to be screened again for 5 years.

For additional information go to: QIAGEN

VIA

Visual inspection of the cervix with acetic acid (VIA) is a low-tech, low-cost method of cervical cancer screening.

BHI believes that low-cost, low-tech screening methods, such as Visual Inspection of the cervix with Acetic Acid (VIA), is an effective low-tech, low-cost method of screening for cervical cancer.

For additional information go to: PATH, JOHNS HOPKINS

TREATMENT

Cryotherapy

Cryotherapy is a gynecological treatment used to freeze and destroy abnormal cervical cells. Cryotherapy treats only pre-cancer. It is not a treatment for cervical cancer.

These systems have been successful in low-income countries where women face significant barriers to screening, and are likely to be lost to follow-up appointments in a multi-visit Pap smear system.

For additional information go to:

WHO guidelines: Use of cryotherapy for cervical intraepithelial neoplasia
http://www.who.int/reproductivehealth/publications/cancers/9789241502856/en/

RESOURCES