Updated: Apr 27
By Sonya Sar
In America, cervical cancer has been one of the leading causes of death in women for decades; however, in the last 40 years, the number of invasive cases and
deaths caused by cervical cancer has significantly decreased.
Before we can really understand what cervical cancer is, we must first look at the different organs and regions that are associated with this disease. The
cervix is a canal that connects the vagina to the upper part of the uterus, which is where the fetus grows during pregnancy. There are two important parts of the cervix, the endocervix and the exocervix. The endocervix is the opening of the cervix that leads to the uterus while the exocervix is the outer part of the cervix.
The transformation zone is where the squamous and glandular cells meet, which are two skin cell types found in the endocervix and exocervix. Some important genes that control when cells grow, divide, and die are oncogenes, which help with cell growth and division, and tumor-suppressor genes, which prevent abnormal cell growth; these two genes are important to prevent the formation of cancer, which is caused by normal tissues that grow out of control.
That was a lot of anatomy and terminology, but don’t worry if you didn’t understand it all. It is important to know that all women are at risk of cervical cancer. It is most frequently diagnosed in women between the ages of 35 and 44, and it is rarely ever found in women under the age of 20. However, women above the age of 65 still make up a significant amount of cases, so it’s important not to rule out anyone above the common age range. It is also important to note that the ages 20-29 are when women are at the highest risk of contracting human papillomavirus (HPV).
Why is this virus of interest? Well, abnormal cells can develop in the cervix, known as cervical intraepithelial neoplasia (CIN). Studies show that an increase in age by one year increases the risk of forming CIN lesions – premalignant lesions found in the cervix – by 1.149 times. However, for these lesions to form, an HPV infection is necessary. Some symptoms of cervical cancer include persistent pelvic, back, or leg pain, pain during urination or needing to urinate a lot, unexplained weight loss (coupled with other symptoms), and heavier or longer menstrual cycles.
HPV is actually the most common cause of cervical cancer. This viral infection is transmitted through skin to skin contact. In this virus, there are two proteins that prevent the tumor suppressor genes from being able to carry out their function; thus, cells in the cervix grow uncontrollably and develop many abnormal changes. However, having HPV doesn’t guarantee that someone will have cancer, since many women contract this virus and end up not getting cervical cancer. However, if HPV is coupled with other known risk factors, then the chances of being diagnosed with cervical cancer increases. Smoking is considered a risk factor since it exposes your body to cancer-causing chemicals, and researchers believe that these substances can damage the DNA in cervical cells. Having a weakened immune system, due to HIV (human immunodeficiency virus) or having had an organ transplant, for example, is also another risk factor. Lastly, having a family history of cervical cancer can also increase your risk.
Normal cells will gradually develop abnormal changes before they can be ruled as reaching the precancerous stage. The pre-cancers of cervical cancer are graded on a scale of 1 to 3. CIN 1 describes a state where not much of the tissue looks cancerous, making it the least serious pre-cancer. CIN 2 and CIN 3 are when more of the tissue starts to look abnormal, with CIN 3 being the most serious pre-cancer stage. If the pre-cancer isn’t discovered and treated, then there is a higher chance that it may become cervical cancer. It takes at least ten years for the pre-cancerous conditions of the cervix to turn into cervical cancer in the transformation zone. The progression of HPV infected cells is a process that requires alterations involving the changes in the oncogenes and tumor suppressor genes, the cancer-related genes mentioned before.
The best way to prevent cervical cancer is regular screening tests, either the pap smear or the HPV test. The pap smear test collects cervical cells so they can be looked at in labs for either cancer or pre-cancer signs. The HPV test looks for pieces of DNA in the cells from the cervix to test for HPV. Another method to prevent cervical cancer on top of screening tests is taking the HPV vaccine, which protects against the types of HPV that causes 0cervical cancer. This vaccine is usually given to preteens, those from the ages of 11-12, but is still available to those older than 12; however, it is not for women over the age of 26.
If one is diagnosed with cervical cancer, there are many forms of treatments. There are various types of surgeries that are offered, like an ablation, which destroys cervical tissue using either cold temperatures or a laser. A simple hysterectomy, which removes the body of the uterus and the cervix, is also an option. However, this treatment can lead to an inability to have children since the uterus has been removed. Another form of treatment is radiation therapy, which uses high energy x-rays to kill cancer and can be used as a main treatment or to treat cervical cancer that has spread or returned after treatment. Chemotherapy is another type of treatment that uses anti-cancer drugs that are injected into the vein or given by mouth. As you can see there are a variety of good treatments available for cervical cancer; however, since this treatment isn’t always a practical option for everyone, it’s more important to take the cautionary steps to prevent cervical cancer such as regular screening and the HPV vaccine.
If you have questions about your health or about cervical cancer in general, feel free to check out the links cited below, but always remember that your doctor is the best resource for making sure you’re staying healthy!
Centers for Disease Control and Prevention. (2021, December 14). Basic Information About
Cervical Cancer. https://www.cdc.gov/cancer/cervical/basic_info/
The American Cancer Society. (2022, January 12). Key Statistics for Cervical Cancer.
The American Cancer Society. (2020, January 3). Risk Factors for Cervical Cancer.
Tuncer, H.A., & Tuncer, S.F. (202). The effect of age on cervical cancer screening in women
Balasubramaniam, S.D., Balakrishnan, V., Oon, C.E., & Kaur, G. (2019). Key Molecular Events
In Cervical Cancer Development. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC668
The American Cancer Society. (2020, January 3). Surgery for Cervical Cancer.
The American Cancer Society. (2020, January 3). Radiation Therapy for Cervical Cancer.
The American Cancer Society. (2020, January 3). Chemotherapy for Cervical Cancer.
Centers for Disease Control and Prevention. (2021, December 14). What Can I Do to Reduce
My Risk of Cervical Cancer? https://www.cdc.gov/cancer/cervical/basic_info/prevention.
The American Cancer Society. (2020) [Picture describing the different parts of the uterus]
[Figure]. The American Cancer Society. https://www.cancer.org/cancer/cervical-
Peng, K., He, L., Wang, B., & Xiao, J. (2015) [Development of cervical cancer] [Figure].