Cervical cancer is among the most common gynecological cancers worldwide and ranks as the 4th most frequent cancer type in women. The cervix is the part that connects the uterus and the vagina.
The primary cause of cervical cancer is the carcinogenic types of the human papillomavirus (HPV), which is sexually transmitted.
Symptoms of Cervical Cancer
The most common symptom of cervical cancer is bleeding outside of the menstrual period. Bleeding, especially after sexual intercourse, is observed in cases of cervical wounds or cancer. While postmenopausal bleeding is most commonly caused by endometrial (uterine lining) cancer, it may also be associated with cervical cancer.
Another frequent symptom is dyspareunia, or painful sexual intercourse. Other early signs include abnormal vaginal discharge and irregular menstrual cycles. In advanced stages, symptoms such as anemia due to abnormal vaginal bleeding, back or leg pain caused by pressure from a mass, frequent urination, and painful urination due to bladder pressure may occur.
During pregnancy, the symptoms do not change; however, cervical cancer does not typically present symptoms in its early stages. Therefore, it is crucial to undergo a gynecological examination and have a cervical cancer screening test called a Pap smear before pregnancy.
- Gynaecologist Op.Dr.Merve Olgun
Causes of Cervical Cancer
As with all cancers, cellular mutations are the primary cause of cervical cancer. The most frequent factor causing cellular mutations in the cervix is sexually transmitted HPV (99%).
HPV is responsible for 99% of cervical cancers. While there are over 100 low-risk HPV types that typically cause genital warts, they can lead to warts in the genital area. Transmission is especially common through unprotected oral, vaginal, and anal sexual contact. High-risk HPV types, particularly HPV-16 and HPV-18, account for 75% of cervical cancers. Additionally, these high-risk HPVs can cause abnormalities in cervical cells.
Risk Factors for Cervical Cancer
- Early onset of sexual activity, unprotected intercourse, and multiple partners increase the risk of HPV transmission and, consequently, cervical cancer.
- Smoking: Smokers are twice as likely to develop cervical cancer compared to non-smokers.
- Weakened immune system: Conditions like HIV or certain medications that impair the immune response increase the risk.
- Unhealthy lifestyle: Poor nutrition and lack of exercise weaken the immune system, raising the risk of cervical cancer.
- Obesity: Overweight and obese women have a higher risk of developing cervical adenocarcinoma.
- Family history: A family history of cervical cancer is another risk factor for cervical adenocarcinoma.
Prevention Methods for Cervical Cancer
Each year, over 500,000 women worldwide are diagnosed with cervical cancer, and nearly half succumb to the disease. Since cervical cancer is nearly entirely preventable, taking precautions is vital.
The primary prevention step is to avoid HPV transmission, the most common cause of cervical cancer. Barrier methods like condoms and avoiding high-risk sexual behavior are fundamental.
Another preventive method is the HPV vaccine, developed to combat HPV types that cause cervical cancer. This effective and safe vaccine can be administered to both girls and boys starting at age 9. Current medical guidelines recommend receiving the HPV vaccine before the first sexual experience and before the age of 25. While it is strongly advised for individuals aged 9–26, it may also be administered to those aged 27–45 based on their risk profile. The HPV vaccine is given in two doses up to age 15 and in three doses after age 15.
How Is Cervical Cancer Diagnosed?
During routine annual gynecological check-ups, patients are asked about their age at first sexual intercourse, whether they experience bleeding or pain after intercourse, and any history of sexually transmitted infections, multiple sexual partners, HPV infection, HPV vaccination, smoking, menstrual cycle irregularities, and recent abnormal bleeding.
During a gynecological examination, external genital organs are evaluated, followed by an ultrasound examination of internal genital organs. Pap smear or liquid-based cytology tests, as well as HPV screening tests in cases of high-risk sexual history, should be performed during a vaginal examination. This allows cervical cancer to be detected at the cellular changes stage.
Performing a Pap smear test at least once every two years during annual gynecological check-ups is crucial for early diagnosis.
It’s important to note that HPV is not only a cause of cervical cancer but also penile cancer in men and anal cancer in both sexes. To prevent cancer, we must avoid high-risk, unprotected sexual intercourse and ensure we receive the HPV vaccine.
Wishing you healthy days ahead!
