Cervical cancer

The incidence of cervical cancer in the UK dropped by 42% in the 10 years following the introduction of the national call-recall system by the NHS Cervical Screening programme in 1988. New diagnostic procedures are also contributing to a decrease in incidence and there is now almost a 70% survival rate for cervical cancer (percentage rates five years after diagnosis) due to new surgical procedures and improved treatments.

What is cancer?

Cervical cancer is cancer of the cervix

How many types of cervical cancer are there?

What are the symptoms of cervical cancer?

What causes cervical cancer?

Important facts to note about HPV

Is cervical cancer infectious?

How common is cervical cancer in the UK?

How is cervical cancer detected?

Is cervical cancer hereditary?

What is the risk of developing cervical cancer?

What is cancer?

All living organisms are composed of one or more cells including the human body, which is made up of cells that are not visible to the naked eye.  Groups of cells form the tissues and organs of the body, all of which have a unique function. Cells usually reproduce themselves by dividing in a regular, orderly fashion so that growth and repair of the body tissues can take place. Sometimes there is an uncontrolled growth of cells causing a swelling or a tumour.

Benign tumours remain contained within a limited area and once treated, often by an operation, do not usually cause any further problems.

A malignant tumour is a growth (group) of cancer cells. Cancer is the result of atypical cell division and is a general term to describe more than 100 diseases that are characterised by uncontrolled, abnormal growth and division of cells. Cancer cells have the ability to travel from one part of the body to another via the blood or lymphatic system; here they may form new tumours called metastases or secondaries. Cancer cells are also able to invade and destroy other tissue around them.

Cervical cancer is cancer of the cervix

The cervix forms the lower part of the uterus and is sometimes described as the neck of the uterus. Cervical cancer is a major health issue for women worldwide. It is the fifth principal cause of cancer deaths in women worldwide - the second principal cause of cancer deaths in women in developing countries. Globally 493,700 cases of cervical cancer are registered every year resulting in approximately 270,000 deaths. Cervical cancer is now described as a 'rare' cancer in the UK accounting for 1% of all cancer deaths in women. Cervical cancer mortality rates generally increase with age, with the highest number of deaths occurring in women aged over 75. Cervical cancer can affect a wide age range and although rare in teenage girls, women in their 20's may develop the disease but less than 6% of cervical cancer deaths occur in women aged under 35.

How many types of cervical cancer are there?

There are two main types of cervical cancer:

• squamous cell
• adenocarcinoma
• other rare types of cervical cancer include clear cell, small cell undifferentiated, lymphomas and sarcomas. Squamous cell cancers are diagnosed in approximately 80% of all cervical cancers. Squamous cell cancers are composed of the flat cells that cover the surface of the cervix and often begin where the ectocervix joins the endocervix.  Adenocarcinoma is diagnosed in approximately 20% of cervical cancers. The cancer develops from the mucous producing glandular cells which line the cervical canal. This type of cancer can be more difficult to detect with cervical screening tests because it develops within the cervical canal. Adenosquamous cancers are tumours that contain both squamous and glandular cancer cells and their incidence is increasing in the UK.
  

What are the symptoms of cervical cancer?

There are usually no symptoms associated with CIN, dysplasia or dyskaryosis. In the early stages of cervical cancer there may also be no symptoms.

If symptoms are experienced they can include:

• Abnormal bleeding: after sexual intercourse, during or between periods
• Post menopausal bleeding, if you are not on HRT or have stopped it for six weeks
  
• Unusual and/or unpleasant vaginal discharge
• Discomfort or pain during sex
• Lower back pain

Women who experience any or all of these symptoms or are concerned about any new symptom should make an appointment to see their GP as soon as possible. However, these symptoms can be associated with many other conditions that are not cancer related.
 
As a cancer develops it can cause additional symptoms:

• Frequency of urine
• Blood in the urine
• Rectal bleeding
• Diarrohea
• Incontinence
• Lower limb lymphoedema

What causes cervical cancer?

Cervical cancer is different to the majority of other cancers in that infection with a virus is present in 99% of all cervical cancers diagnosed. Research has now shown that an infection with specific types of human papilloma virus (HPV) is a major factor in the development of a cervical cancer. Other factors associated with an increased risk of the development of abnormalities in cells in the cervix include:

• Smoking
• Sexual activity at a young age (aged 17 or under)
• Several sexual partners
• Weakened immune system
• Poor diet
• Effect of DES (diethylstilboestrol)

For further information about the effect of DES: www.des-action.org.uk

Important facts to note about HPV  

• HPV is a very common virus. Research states that 75% of the world's population (men and women) will come into contact with HPV at some time during their lives
• Your first sexual experience puts you at risk of infection 
• Infection with HPV does NOT imply either infidelity or promiscuity
• HPV infection can reside in the body without causing any problems for many years
• HPV is more commonly known (but misleadingly so in regard to cervical cancer) as the 'wart virus' 
• HPV infection, in itself does not require treatment in a woman or indeed her male partner

Is cervical cancer infectious?

Cancer of the cervix is not infectious and cannot be passed on to other people. It is not transmitted via sexual intercourse, from a mother to her unborn child or via breastfeeding. 

How common is cervical cancer in the UK?   

Between 2,800 and 3,000 new cases of cervical cancer are registered each year in the UK. Of this number approximately 1,000 will die from the disease each year. The number of deaths from cervical cancer has fallen dramatically since the launch of the NHS Cervical Screening Programme in 1988. This is due to the abnormalities being diagnosed at a pre-cancerous or early cancer stage.

Research states that screening prevents approximately 3,900 cases of cervical cancer and saves 4,500 lives every year. Cervical cancer is the second most frequent cancer amongst young women (aged 15-44) in Europe - the importance of screening remains critical in the well being of women.

How is cervical cancer detected?

The best method of detecting cervical cancer is for women to attend for regular cervical screening.

Cervical screening began in UK in the mid-1960s and the NHS Cervical Screening Programme was launched in 1988 when the Department of Health instructed all health authorities to introduce computerised call-recall systems and to meet certain quality standards.

The cervical screening programme's aim is to reduce the number of cases of cervical cancer and to prevent those who are diagnosed from dying of the disease, by the early detection of cervical cell changes, which if undetected could at a future time develop into cervical cancer. A woman should always see her GP (whether or not she has had a recent cervical smear test) if she has any new or persistant symptoms that may indicate that she has a cervical abnormality.

Is cervical cancer hereditary?  

Cervical cancer is not caused by genetic changes that can be passed down through families, so is not thought to be hereditary.

What is the risk of developing cervical cancer?

The risk of developing cervical cancer is approximately 1 in 10,000 women.

Between 3.6 and 4 million women have a smear test every year and 90% of them receive a normal result. Cervical cancer accounts for about 2% of all cancers found in women. The peak incidence of cervical cancer occurs between the ages of 40 to 55. It is rare in teenage girls, although women in their 20's may develop the disease. 6% of cervical cancer deaths occur in women aged under 35.

Last Updated: 08 Feb 2008