Cervical Cancer

Cervical cancer is the number one cause of cancer-related deaths of women on the African continent. All women are at risk, including lesbians. In South Africa, 1 in 42 women get cervical cancer, which, after breast cancer, is the second most common cause of cancer amongst South African women. Over half of the women diagnosed are between the ages of 35 and 55. Early cervical cancer can be cured.

What is cervical cancer?

Cervical cancer is a cancer that forms in a woman’s cervix. The cervix is the lower narrow end of the uterus that forms a canal between the uterus and the vagina. When the normal cells that make the cervix start to grow out of control and abnormally, they are called cancer cells. These cancer cells have the ability to spread directly to surrounding structures like the bladder or the bowel. In advanced disease the cancer cells get into the bloodstream and spread to distant organs like the liver, lungs, bone or brain.

Human papillomavirus (HPV) is a virus that is passed between man and woman and also WSW during sex. Both men and women can be infected with HPV. When exposed to HPV, a woman’s immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells. HPV is associated with almost all cervical cancer cases worldwide. HPV can also cause benign warts on the vulva, in the vagina, anus and penis.

Anatomy of the female genital tract

Cervical Cancer

Who is more likely to get cervical cancer?

Women with multiple sexual partners, sexually transmitted infections and women who have their first sexual encounter at a very young age are at higher risk. This is because there is a higher likelihood of being exposed to and infected with HPV. Also older women (over the age of 30), HIV-positive women, smokers and women using birth control pills for five or more years are at higher risk. Your genes may also predispose you to this cancer. Any woman can get cervical cancer but the above risk factors make getting cervical cancer more likely.

What are the symptoms?

Early on you won’t have any symptoms or signs. As the cancer grows with time it may cause bleeding or a vaginal discharge.

The bleeding is typically not related to your period and may occur after sex.

With advanced late stage cancer, where the cancer has invaded surrounding organs and spread to distant organs, the symptoms will vary depending on which organ is affected. You may experience any or a combination of the following symptoms: lower back pain, weight loss, loss of appetite, feeling tired, problems when passing urine and/or stool, abdominal pain or bone pain, coughing and shortness of breath and seizures.

Can we prevent cervical cancer?

Cervical cancer can be prevented by two means: vaccination at a young age and regular screening tests.

  • Vaccination
    Getting the HPV vaccine. Two vaccines are available currently in South Africa and have shown to prevent infection with the two types of HPV that cause most cervical cancers. The vaccines do not protect women who are already infected with HPV. The HPV vaccines are hence recommended to be administered in early teenage years, before girls become sexually active. The age group may be extended to 26-years-old, provided you are not sexually active.

    The South African National Department of Health is currently running a HPV Vaccination Programme in all public schools, providing all grade four girls (9 to10-year-olds) with the opportunity to receive the HPV vaccination for free.

  • Screening tests
    The Pap smear (or Pap test) looks for precancers – cell changes on the cervix that can be treated so that cervical cancer is prevented. This is a simple procedure where the doctor or nurse scrapes off some cells from the cervix and sends it to the laboratory. The cells are viewed under a microscope, after staining, to find out if the cells are abnormal.

    Cervical cancer starts as a pre-cancerous condition called dysplasia. This pre-cancerous condition can be detected by a Pap smear and is 100% treatable. That is why it is so important for women to get regular Pap smears done.

    Ideally a Pap smear is recommended in women every 3 years from the age of 25.

How the doctors test for cancer of the cervix?

Your doctor will examine you carefully and do a Pap smear. If there is an obvious lesion on examination he/she will immediately take a piece of the growth (a biopsy) to have it analysed in the laboratory. The doctor may also use a laboratory test to check for certain types of HPV such as HPV serotype 16 and 18, which are strongly linked to cervical cancer.If you test positive for cancer the doctor may request further tests to determine if the cancer has spread.