The cervix is known as the neck of the womb, and is a narrow muscular opening connecting the vagina to the womb (uterus). Cancer can affect any of the cervix. Cervical cancer is most commonly caused by certain strains of a virus called Human Papilloma Virus (HPV). The risk of cervical cancer is much reduced with both the UK’s cervical screening programme and the HPV vaccination programme. It's a relatively uncommon cancer but receives a lot of attention as it is so easily prevented if early cell chances are caught early, and because it affects young women who are otherwise healthy and at low risk of other cancers.
HPV is the biggest risk factor in developing cervical cancer. It’s a very common virus, contracted through any sexual or genital contact, including oral, anal and oral sex, sharing sex toys, or any genital skin-to-skin contact. It should carry no embarrassment or shame, you can contract it if you've had one sexual partner or lots, or if you are in a same-sex relationship, and it can be transmitted through vaginal, oral or anal sex, sharing sex toys or any genital skin contact. You or your partner won’t have symptoms, and your body can naturally clear HPV with time. Certain strains of HPV cause changes to cervical cells that are considered pre-cancerous. If left untreated, over months to years, they can develop into cancer cells.
Both girls and boys aged 12 to 13 will be offered an HPV vaccine. This is hopefully before they become sexually active, to prevent them from getting HPV in the first place. The UK cervical screening programme is offered to all women aged 25 to 64. The smear test or pap test takes a sample from the cervix looking for the presence of HPV and, if present, any changes to cells (dysplasia). If found, treatment is offered in a procedure called a colposcopy to remove the area of abnormal cells, thus preventing cancer. Research suggests that 99.8% of cervical cancers are preventable. Smoking puts you at higher risk of cervical cells becoming abnormal. It’s also thought to reduce the chance of your immune system being able to clear HPV from your body. Up to 21% of cervical cancers are related to smoking. Those from deprived communities in England are at significantly higher risk of developing cervical cancer, and it’s more common in Caucasian than Asian or Black ethnicities – more something to be aware than anything you have control over.
Cervical cancer is slow-growing, so the best you can do is maintain your cervical screening appointments when invited. This is every 3 years for those aged 25 to 49 and every 5 years from 50 to 64. If you develop symptoms at any point, it’s best you don’t wait for your next smear test, book an appointment with your doctor. Symptoms include pain during sex, bleeding after sex or between periods, or unusual or bloody discharge. There can be a number of causes for this, and your doctor will ask about your symptoms, your smear test history and other relevant factors, and they will ask you permission to perform an intimate examination. They can refer you urgently if they have concerns about cervical cancer.
If your smear test shows abnormal cells, your doctor will refer you for a procedure called a colposcopy. The area of abnormal, or pre-cancerous cells can be treated in a number of ways, and treatment is usually definitive. You will be followed up with a smear test, usually 6 months later, and you will have smear tests more often for a few years. If the clinician finds cervical cancer, treatment options depend on the grade of the cancer, any spread to other organs, and your general health. It may be treated with surgery, radiotherapy, chemotherapy, targeted medicines or a combination. Treatment may have implications for your fertility and ability to carry a baby. The team in charge of your care will discuss the risks and options with you. For any cancer, most people want to know whether it will affect their survival. This depends on a number of factors, but around 3200 women a year are diagnosed, and 80% survive beyond the first year, 60% survive for 5 years or more. Those less than 40 have a much higher chance of success than those who are older at diagnosis.