What Is Cervical Cancer?

Cervical cancer is a cancer of the cervix, or the outer entrance to the uterus (womb). It develops slowly, long after abnormal or "dysplastic" changes may be detected in the cervical cells by routine Pap smears. It usually affects women between the ages of 30 and 55. Worldwide, there are expected to be 490,000 new cases diagnosed this year; cervical cancer is the third most common cancer affecting women (after skin cancer and breast cancer). In the United States, there are 10,370 new cases expected to be diagnosed in 2005, while 3,710 cervical cancer-related deaths are predicted.

Cervical cancer is most frequently diagnosed by routine Pap smears; a newer test called the "DNA with Pap" enhances diagnosis by detecting the presence of human papilloma virus (HPV). Although cervical cancer is most frequently diagnosed in women without symptoms--or unaware of their symptoms--there may be subtle symptoms. These include bleeding or spotting after intercourse; excessive vaginal discharge; or abnormal, irregular bleeding between periods.

The good news is that cervical cancer may be diagnosed and treated and that we can identify the cause. Numerous medical studies have confirmed HPV is associated with 99% of cervical cancer cases. In addition to having had an HPV infection, other risk factors for cervical cancer include:

• history of genital warts, herpes simplex or any STD
• history of previous abnormal pap smears
• smoking, or abusing other substances, including alcohol
• having a mother who took the drug DES (diethylstilbestrol) during pregnancy to prevent miscarriage (1940-1970)
• having HIV/AIDS
• having an impaired immune system
• having a male sexual partner who has had a sexual partner with cervical cancer
• having a family history of cervical cancer
• lower socioeconomic status
• having a personal or family history of lower genital tract dysplasia or cancer
• having giving birth to several children
• longtime birth control pill usage
• having a co-infection with herpes simplex virus (HSV) or chlamydia

Over the past 50 years, the death rate from cervical cancer -- once one of the most common and lethal cancers in women in the United States -- has decreased by 74%, mostly due to the widespread use of the Pap smear. When cervical cancer is detected early, the five-year survival rate is 92 percent; when detected in its most advanced stages, the five-year survival plummets to 16%. At all stages, five-year survival rates are significantly lower for African American women than white women.

Unfortunately, most women who die from cervical cancer have not had a Pap smear in more than 5 years. The good news is that thanks to advances in cervical cancer prevention, screening and treatment, their prognosis is likely to be good. The most exciting advance on the horizon is the development of HPV vaccines to prevent the most common type of virus that causes cervical cancer.

Created: 3/7/2005  -  Donnica Moore, M.D.