Overview

What is cervical cancer? A Mayo Clinic expert explains

Learn more about cervical cancer from Mayo Clinic gynecologic oncologist Kristina Butler, M.D., M.S.

I'm Dr. Kristina Butler, a gynecologic oncologist at Mayo Clinic. In this video, we'll cover the basics of cervical cancer: What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Cervical cancer happens when cells in the cervix, the lower part of the uterus that connects to the vagina, start to become abnormal. Small changes in the cell DNA tells them to multiply out-of-control, and cells accumulate in growths called tumors. Thankfully, advances in medical technology and specifically the use of Pap tests, have significantly helped us identify cervical cancer in patients earlier than ever before. What was once the most common cause of cancer death for American women is now caught sooner and therefore more curable.

Who gets it?

While it isn't perfectly clear what sparks the cervical cells to change their DNA, it is certain that human papilloma virus, or HPV, plays a role. HPV is spread by skin to skin contact often during sexual encounters. Over 85% of the general population has been exposed. But most people with HPV never develop cervical cancer. However, reducing your risk of one helps reduce your risk of the other. I recommend getting both the HPV vaccine and regular screening tests. Other risk factors for cervical cancer include multiple sexual encounters. But it only takes one to contract HPV, so it's important to always practice safe sex. A weakened immune system and also smoking are linked to higher risk. One drug called DES was popular in the 1950s as a miscarriage prevention drug. So if your mother took it while pregnant, you may have higher risk as well.

What are the symptoms?

Unfortunately, the early stages of cervical cancer generally show no signs or symptoms. And this is why we emphasize getting Pap smears every three to five years and yearly pelvic exams. Once the cancer has progressed, it can show these symptoms: Unusual vaginal bleeding, for example, after intercourse or between periods or after menopause. Watery, bloody vaginal discharge that may be heavy or have an odor. And pelvic pain or other pain can also occur during intercourse.

How is it diagnosed?

Most guidelines suggest starting regular screening for cervical cancer at age 21. And during these screenings, a provider collects cells from the cervix to be tested in the lab. HPV DNA tests examine the cell specifically for HPV that can lead to pre-cancer. A Pap test, or commonly called a Pap smear, tests the cells for abnormalities. The process of these tests are not painful but can be mildly uncomfortable. If your provider suspects cervical cancer, they may start a more thorough examination of the cervix. This may include a colposcopy, which is a special tool that shines light through the vagina into the cervix to magnify the view for your provider. During the colposcopy, your provider might take several deeper samples of cells to examine. This could include a punch biopsy that collects tiny samples of cells, or an endocervical curettage that uses a narrow instrument to take an internal tissue sample. And if after further examination, the sample tissue is worrisome, your doctor may run more tests or collect other tissue samples from deeper layers of the cells. This could use a LEEP or cone biopsy procedure to give the clearest picture possible.

How is it treated?

Treating cervical cancer isn't one-size-fits-all. Your doctor will consider the whole picture of your health and your personal preferences before making a recommendation. And this will include one or several treatment methods. For early cervical cancer, we typically treat with surgery to remove the abnormal growths. For more advanced cervical cancer, there's also chemotherapy, a drug that runs the body killing cancer cells in its path. Radiation therapy uses high-powered beams with energy focused on the cancer cells. There's also targeted drug therapy that blocks specific weaknesses present within the cancer cells. And immune therapy, a drug treatment that helps your immune system recognize cancer cells and attack them.

What now?

No one can be prepared for a cancer diagnosis. However, there are ways we can help reduce anxiety and feel more in control of the situation. Learning about the condition can make you feel more empowered and confident in the decisions about your care. So ask lots of questions and request additional resources. Find support. Ask for help from your family and friends. If you feel more comfortable expressing yourself in a support group, there are many available both online and in-person. Set goals that you can achieve and feel good about. And most importantly, take care of yourself. This time can be difficult and fatiguing. Eat well, relax and get enough rest. If you'd like to learn even more about cervical cancer, watch our other related videos or visit mayoclinic.org. We wish you well.

Cervical cancer is a growth of cells that starts in the cervix. The cervix is the lower part of the uterus that connects to the vagina.

Various strains of the human papillomavirus, also called HPV, play a role in causing most cervical cancers. HPV is a common infection that's passed through sexual contact. When exposed to HPV, the body's immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years. This contributes to the process that causes some cervical cells to become cancer cells.

You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

When cervical cancer happens, it's often first treated with surgery to remove the cancer. Other treatments may include medicines to kill the cancer cells. Options might include chemotherapy and targeted therapy medicines. Radiation therapy with powerful energy beams also may be used. Sometimes treatment combines radiation with low-dose chemotherapy.

Symptoms

When it starts, cervical cancer might not cause symptoms. As it grows, cervical cancer might cause signs and symptoms, such as:

  • Vaginal bleeding after intercourse, between periods or after menopause.
  • Menstrual bleeding that is heavier and lasts longer than usual.
  • Watery, bloody vaginal discharge that may be heavy and have a foul odor.
  • Pelvic pain or pain during intercourse.

When to see a doctor

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

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Causes

Cervical cancer begins when healthy cells in the cervix develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The changes tell the cells to multiply quickly. The cells continue living when healthy cells would die as part of their natural life cycle. This causes too many cells. The cells might form a mass called a tumor. The cells can invade and destroy healthy body tissue. In time, the cells can break away and spread to other parts of the body.

Most cervical cancers are caused by HPV. HPV is a common virus that's passed through sexual contact. For most people, the virus never causes problems. It usually goes away on its own. For some, though, the virus can cause changes in the cells that may lead to cancer.

Types of cervical cancer

Cervical cancer is divided into types based on the type of cell in which the cancer begins. The main types of cervical cancer are:

  • Squamous cell carcinoma. This type of cervical cancer begins in thin, flat cells, called squamous cells. The squamous cells line the outer part of the cervix. Most cervical cancers are squamous cell carcinomas.
  • Adenocarcinoma. This type of cervical cancer begins in the column-shaped gland cells that line the cervical canal.

Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.

Risk factors

Risk factors for cervical cancer include:

  • Smoking tobacco. Smoking increases the risk of cervical cancer. When HPV infections happen in people who smoke, the infections tend to last longer and are less likely to go away. HPV causes most cervical cancers.
  • Increasing number of sexual partners. The greater your number of sexual partners, and the greater your partner's number of sexual partners, the greater your chance of getting HPV.
  • Early sexual activity. Having sex at an early age increases your risk of HPV.
  • Other sexually transmitted infections. Having other sexually transmitted infections, also called STIs, increases the risk of HPV, which can lead to cervical cancer. Other STIs that increase the risk include herpes, chlamydia, gonorrhea, syphilis and HIV/AIDS.
  • A weakened immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
  • Exposure to miscarriage prevention medicine. If your parent took a medicine called diethylstilbestrol, also known as DES, while pregnant, your risk of cervical cancer might be increased. This medicine was used in the 1950s to prevent miscarriage. It's linked to a type of cervical cancer called clear cell adenocarcinoma.

Prevention

To reduce your risk of cervical cancer:

  • Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your health care team if an HPV vaccine is right for you.
  • Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix. These conditions can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.
  • Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections. This may include using a condom every time you have sex and limiting the number of sexual partners you have.
  • Don't smoke. If you don't smoke, don't start. If you do smoke, talk to a health care professional about ways to help you quit.

Sept. 02, 2023

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