What Is Cervical Cancer? Can It Be Prevented?

Cervical cancer occurs when cells of the cervix become cancerous. The cervix is the lower part of the uterus connected to the upper part of the vaginal canal.

Each year, about 11,500 new cases of cervical cancer are diagnosed in the United States and about 4,000 women die from this cancer, according to the Centers for Disease Control and Prevention (CDC).

Early on, cervical cancer may not cause signs and symptoms. It often develops gradually with normal cells transforming into precancerous cells and eventually cancerous ones.

“Not all precancerous cervical cells will become cancerous, but some will, so it is important to detect changes and treat them, if necessary,” says Dr. Janco.

As the disease progresses, it may present certain warning signs.

Dr. Janco says certain symptoms demand immediate medical attention, such as:

• A significant change in vaginal discharge, including an unusual smell or brown or pink color
• Pain or bleeding outside your regular menstrual cycle
• Irregular menstrual cycles
• Post-menopausal vaginal bleeding even if spotting or light

Most cervical cancers are linked to certain strains of human papillomavirus, HPV. The virus can be transmitted through sexual contact. 

Many HPV infections will be cleared by the body and many more will be suppressed or become dormant. But a small number will remain or become active. About 10 percent of women with HPV infection on their cervix will develop long-lasting HPV infections that put them at high risk for cervical cancer.

“Many people are exposed to HPV, and it does not become an issue for them,” Dr. Janco says. “But it is very important to take care of yourself and consider getting the HPV vaccine to prevent cervical cancer, stay up to date with screenings and be evaluated for any abnormal symptoms, so that any changes can be caught early.”

HPV vaccination is recommended for individuals up to age 45. It is most effective when given during childhood or early adolescence.

“The earlier you get it, the better. It’s protective and can even reduce risk of head and neck cancer, as well,” Dr. Janco says.

Cervical cancer rates have dropped in the United States since the HPV vaccine became available in 2006.

Medical conditions like HIV and certain medications that suppress the immune system can elevate the risk of cervical cancer.

Smoking, especially when combined with HPV infection, can increase the risk of cervical cancer. This makes it particularly important for women to avoid smoking.

Cervical cancer is most common in women over age 30. The average age of diagnosis is 50. Regular screenings before the age of 65 can significantly reduce the risk.

Having multiple sexual partners and engaging in unprotected sex can increase the risk of HPV infection.

Condom use has been associated with a lower rate of cervical cancer.

This sexually transmitted infection can also raise the risk of cervical cancer.

The risk of cervical cancer may increase with prolonged use of oral contraceptives, though they may offer protection against other types of cancers, including ovarian and endometrial cancers.

Consider an individualized contraception plan with your physician if you are concerned about the impact of birth control pills on your cervical cancer risk.

Women who have carried three or more pregnancies to term have a higher risk.

A family history of cervical cancer, especially women in a mother or sister, can elevate your risk.

If your mother was treated with DES during pregnancy, you may have a higher risk of cervical cancer. DES was used until 1971 to prevent miscarriage.

Regular screenings, including pelvic exams, Pap tests (Pap smears) and HPV tests, are crucial for early detection. Many cervical dysplasias or abnormal growths and cancers do not cause symptoms and are detected only by screening.

Discuss with your healthcare provider to determine the best screening schedule based on your individual risk factors. Pap tests are usually recommended starting at age 21.

When cervical cancer is found before it has spread beyond the cervix, the 5-year survival rate is 92%.

Free or low-cost screenings are widely available for women who have low incomes and are uninsured or underinsured.

Screening tests include:

Pelvic exam: This examines the vulva, vagina, and cervix. A biopsy may follow if there are any visible abnormal growths.

Pap test: This test collects cervical cells to identify abnormal changes. It is done during a pelvic exam by collecting cells from the cervix with a brush.

HPV test: This checks for active HPV infection. HPV and Pap tests can be done at the same time.

“Your doctor can discuss with you how often you need these tests and perform them during your well woman exam. Depending on your prior screening and personal risk factors, you may need to be screened more often,” Dr. Janco says.

While Pap and HPV testing for low-risk women can be spaced, women should continue regular pelvic examination or well woman exam. 

Treatment depends on whether there is pre-cancer or cancer, and if it has spread. At Scripps, treatment for cervical cancer is individualized depending on the stage and type of cervical cancer. Treatment may include surgery, radiation, chemotherapy, or a combination.

“Any procedure will depend on the patient’s diagnosis and other factors, such as fertility, reproductive plans and prior treatment,” Dr. Janco says.

Fertility-sparing treatments are possible in some cases for women who plan to get pregnant.

Various procedures can be used to remove abnormal cells or affected tissue, such as:

• Cryosurgery
• Laser surgery
• LEEP (loop electro-surgical excision procedure)
• Cone biopsy
• Trachelectomy, the removal of the cervix
• Hysterectomy, the removal of the uterus

• Radiation therapy, where high-energy rays are used to target and destroy cancer cells
• Chemotherapy, where medications are used to kill cancer cells or inhibit their growth
• Combination therapy, which often involves surgery, radiation and chemotherapy