What is Cervical Cancer?
Cervical cancer is cancer of the cervix. The cervix is the lower part of the uterus (womb), which opens into the vagina.

How common is cervical cancer?
The American Cancer Society estimates that in 2004, about 10,500 women in the United States will develop cervical cancer and about 3,900 will die from it.ⁱ Worldwide, cervical cancer is the second-most-common type of cancer that strikes women – behind only breast cancer.ⁱⁱ

The good news is that the number of American women with cervical cancer has decreased about 75 percent in the past 50 years – largely thanks to the Pap test.

The bad news is that too many women are still getting cervical cancer and are still dying. This, however, can change for the better.

• First, all women need to be screened regularly.
• Second, there is now a test that can detect high-risk types of HPV, it can be combined with a Pap in women 30 years of age and older (those who are most likely to develop cervical cancer). This will increase doctors’ ability to determine which women are at risk.

What causes cervical cancer?
High-risk types of the human papillomavirus (HPV) cause nearly all (99.7 percent) cervical cancer cases.ⁱⁱⁱ

Almost every woman will get HPV at least once in her life. The body’s immune system usually fights off the virus, and most women with HPV never suffer any problems as a result.

In some women, however, the virus does not go away. When the virus stays in the body for a long period of time, cervical cells may begin to change and the risk of cervical cancer increases.

Are there other causes of cervical cancer?
HPV is the cause of nearly all cervical cancers. However, there is evidence that other factors may increase your risk when combined with HPV. These include:^v

• Smoking
• Illnesses that reduce the body’s ability to fight off infections (such as HIV/AIDS)

Some, less reliable data suggest that other risk factors may include a family history of cervical cancer, long-term use of oral contraceptives (greater than five years) and conditions that can damage the cervix, such as chlamydia infection.

How long does it take for cervical cancer to develop?
Once cervical cells begin to change, it typically takes 10-15 years before cancer develops. As the cells change, they can become "pre-cancerous" – a condition also known as "dysplasia" or CIN – the abbreviation for cervical intraepithelial neoplasia.

If detected early, dysplasia can be treated before the cells become cancerous.

What can I do to prevent cervical cancer?
The best way to help protect yourself is to get screened regularly with both a Pap and HPV test. Together, these tests determine if you are likely to have or to develop abnormal cells that could become cervical cancer. If your Pap looks abnormal, and/or if repeat HPV testing shows you have an infection with a high-risk type of the virus that has not gone away, your healthcare provider can perform an additional exam called a colposcopy to determine if there is a problem. If there is a problem, it can be treated before cancer develops.

How is dysplasia or cervical cancer treated?

• Dysplasia

  If the abnormal cell changes are very mild (often referred to as mild dysplasia or CIN-1), your healthcare provider will likely advise just "watchful waiting," since the changes often go away on their own within one or two years. Moderate or severe dysplasia (CIN-2 or 3) can easily be treated, using one of several procedures to remove the cells:

  • Cryosurgery. Abnormal cells are destroyed by freezing them.
  • Laser therapy. A powerful beam of light destroys abnormal cells.
  • LEEP (Loop Electrosurgical Excision Procedure). A very thin, electrically charged wire is used to cut out the abnormal cells.
  
  There is no usually no need for a hysterectomy or other surgery with cervical dysplasia.

• Cervical cancer

  If you have cervical cancer, your physician(s) will discuss the best treatments with you. The options available to you will depend on your personal medical condition and situation. Treatment typically involves surgery to remove the uterus and/or radiation therapy or chemotherapy.

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i. American Cancer Society. What are the key statistics about cervical cancer? Available at:
http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_cerv. Accessibility verified August 9, 2004.
ii. Digene Corporation. HPV & cervical cancer. Available at http://www.digene.com/media_3.html. Accessibility verified August 6, 2004.
iii. McDonald K. The HPV connection. For the Record. 2004 Apr 19; 16 (8): 30-33.
iv. McDonald K. The HPV connection. For the Record. 2004 Apr 19; 16 (8): 30-33.
v. American Cancer Society. Cervical Cancer. Available at: http://documents.cancer.org/115.00/115.00.pdf. Accessibility verified August 2, 2004.