On this page: The cervix | Cervical cell changes | What is cervical cancer? | What types are there? | What are the causes? | How common is it? | What are the symptoms? | What is a Pap smear? | What is the HPV vaccine? | Reviewers
The cervix is the lower, cylinder-shaped part of the uterus that connects to the vagina. It's also called the neck of the uterus. It has an outer surface that opens into the vagina and an inner surface that faces into the uterus. The inner part is called the cervical canal.
The functions of the cervix include:
The cervix is covered by two kinds of cells, which line the surfaces of many organs and body systems:
Sometimes the cells in the cervix start to change and no longer appear normal. This may mean you have a pre-cancerous lesion, which is not cancer but may lead to cancer. Cervical cell changes may be found during a routine Pap smear..
There are different types of early cell changes, which are also called epithelial abnormalities.
If the results from a Pap smear show that your cervix has some abnormal changes, your doctor will recommend that you have one of the following based on the grade of the changes:
"My doctor said that because I had regular Pap smears, the cancer was picked up while it was small. The treatment was straightforward and my body is intact." – Jenny, 34
Cervical cancer is a malignant tumour found in the tissues of the cervix. It occurs when abnormal cells in the cervix turn into cancer cells. The cancer cells break through the surface cells (epithelium) and the underlying tissue (stroma) of the cervix.
Cervical cancer most commonly begins in the cells of the transformation zone. At diagnosis, the cancer is often just within the cervix, but it may spread to tissues around the cervix (e.g. the vagina) or to other parts of the body.
A: The two main types of cervical cancer are named after the cells they start in.
The main cause of cervical cancer is now known to be infection with human papillomavirus (HPV). There are also other known risk factors.
Most cases of cervical cancer occur many years after infection with a strain of human papillomavirus, which is the name for a group of wart viruses. It's a common infection affecting the surface of different body areas, such as the skin, vagina and cervix.
About eight out of ten women will become infected with genital HPV at some time in their lives. Genital HPV is usually spread via the skin during sexual contact. In most women, the virus is cleared quickly by the immune system and no treatment is needed. Because there are rarely symptoms, most women are unaware they have the virus.
The pre-cancerous cell changes caused by HPV can be found by a Pap smear. There's now also a vaccination against HPV.
Chemicals in tobacco can damage the cells of the cervix and make cancer more likely to develop.
If you have a first-degree relative (mother or sister) who has had cervical cancer, you have an increased chance of developing it too.
DES is an oestrogen-based medication prescribed to women from the 1950s to the early 1970s to prevent miscarriage. Although rare, studies have shown that the daughters of women who took DES have an increased risk of developing a rare type of adenocarcinoma.
In Australia, about 750 women are diagnosed with the disease every year. Only 1.6% of all cancers in women in Australia are cervical cancer.
Between 1999 and 2008, the incidence rates of cervical cancer fell by 25%. This is probably because more regular Pap tests are conducted as part of the National Cervical Screening Program. With the introduction of the National Immunisation Program against HPV, there should be a further fall in cervical cancer cases in the coming years.
If early cell changes develop into cervical cancer, the most common symptoms include:
These symptoms can also be caused by other more common conditions. However, see your general practitioner (GP) if you're worried or the symptoms are ongoing. If necessary, your GP will refer you for tests to see if you have cancer.
The main role of the Pap smear (also called a Pap test) is to help prevent cancer. It shows whether women have abnormal pre-cancerous cells in their cervix. If necessary, you'll have treatment so that they don't develop into cancer. If you have a test that shows abnormal cells, you can also be monitored regularly to check the health of the cervix.
All women under 70 years of age who are or who have ever been sexually active should have a Pap smear every two years. Women who have had abnormal cell changes should be tested more often.
During a Pap smear, a doctor uses an instrument such as a brush or spatula to scrape some cells from the surface of the cervix. This may feel slightly uncomfortable but usually only takes a minute or two. The cells are smeared onto a glass slide or put into a fluid. The cells will then be examined under a microscope for any changes.
Occasionally cancer cells are detected in a Pap smear, but this is uncommon. A Pap smear is not used to diagnose cancer – if cancer is suspected, you'll need other tests. If you have an abnormal result, your GP or gynaecologist will discuss whether you need treatment, further tests or another Pap smear at an earlier interval than two years.
The National HPV Vaccination Program was introduced to Australia in 2007. The HPV vaccine provides protection against the two main strains of HPV that are known to cause cervical cancer.
The vaccine, however, can't be given to treat cancer once a woman has already been diagnosed with pre-cancerous cells or cancer. It also doesn't provide protection against all types of HPV, so it's important to continue to have Pap smears even if you've been vaccinated.
For more information, talk to your doctor or see the website www.immunise.health.gov.au.