What Is Cervical Cancer?

Cervical cancer results from uncontrolled, untreated growth of abnormal cells in the cervix. A sexually transmitted infection, the human papillomavirus (HPV), causes such cells to develop and grow.

HPV is found on skin in the genital area, in semen, and also in the tissues of the vagina, cervix, and mouth. It is primarily transmitted through skin-to-skin contact. Vaginal, anal, and oral sex also can spread HPV. Over 50 types of HPV can infect the cervix; 6 of them account for nearly all cervical cancers. Other types of HPV cause genital warts.

An estimated 50% to 80% of sexually active women are infected with HPV at least once in their lives. In most cases, the HPV infection clears on its own. In some women, however, HPV persists and causes precancerous growths, which can develop into cancer. Overall, less than 5% of all women with persistent HPV infection get cervical cancer.

Cancer of the cervix usually takes 10 to 20 years to develop, and so there is a long period of opportunity to detect and treat changes and precancerous growths before they become cancer. This is the goal of cervical cancer screening.

Who Is at Greatest Risk?

Some factors make women more likely to be infected by HPV. Others help HPV infection progress to cervical cancer more quickly. A woman with any of these characteristics would benefit especially from screening:

• Started having sex before age 18
• Has many sexual partners now or over the years
• Has a sexual partner who has or has had many other sexual partners
• Had many births (the more births, the greater the risk)
• Has a weak immune system (includes women with HIV/AIDS)
• Smokes cigarettes
• Burns wood indoors (as for cooking)
• Has had other sexually transmitted infections
• Has used combined oral contraceptives for more than 5 years

Screening and Treatment

Screening for cervical cancer is simple, quick, and generally not painful. A Papanicolaou (Pap) smear involves scraping a few cells from the cervix and examining them under a microscope. A woman will need to go to a facility for results and for treatment if an abnormality is found.

Before precancers become cancer, they can be frozen away with a probe filled with dry ice (cryotherapy) or cut away using a hot wire loop (loop electrosurgical excision procedure [LEEP]). Freezing is less effective for larger growths, but LEEP requires electricity and more extensive training. No hospital stay is needed for either type of treatment.

Treatment for cervical cancer includes surgery or radiation therapy, sometimes together with chemotherapy.

Promising New Approaches to Screening and Prevention

An alternative to the Papanicolaou smear is being tested. The cervix is coated with either vinegar or Lugol's iodine, which makes any abnormal cells visible to the provider. This makes possible immediate treatment if needed.

In 2006 the European Union and the United States Food and Drug Administration approved the first vaccine against cervical cancer, precancer, and genital warts. The vaccine protects against infection by 4 types of HPV that account for about 70% of all cervical cancers and an estimated 90% of all genital warts. It is approved for use among females age 9 to 26 years.