What is Cervical Cancer?

What is Cervical Cancer?

Cervical cancer is the growth of abnormal cells in the lining of the cervix. These abnormal cells can develop into tumours and in worst case scenarios – spread throughout the body. The cervix is part of the female reproductive system and is the narrow lower portion (or “neck”) of the uterus.

There are two main types of cervical cancer which are named after the cells they start in:

  • Squamous cell carcinoma: the most common type of cervical cancer (about 80% of all cases), squamous cell carcinoma starts in the squamous cells of the cervix.
  • Adenocarcinoma: a less common type of cervical cancer that develops from the glandular cells. Adenocarcinoma is more difficult to diagnose because it starts higher in the cervix, and is more difficult to reach with the brush or spatula used in a Cervical Screening Test.

The cervix
The cervix is the narrow, lower part of the uterus, which connects to the upper end of the vagina. This is often referred to as the neck of the womb and is a part of the female reproductive system. It has an inner surface that is facing into the uterus, which is called the cervical canal – whilst the outer surface opens into the vagina. The cervix has various functions including:

  • Producing moistness to lubricate the vagina
  • Producing mucus that helps sperm travel up to the Fallopian tube to fertilise an egg from an ovary
  • Holding a developing baby in the uterus during pregnancy
  • Widening so the baby can be born via the birth canal (vagina).

Two types of cells, which line the surfaces of many organs and body systems, cover the cervix:

  • Squamous cells: these are flat, thin cells found in the outer layer of the cervix that opens into the vagina
  • Glandular cells or columnar cells: column-shaped cells that produce cervical mucus and are found in the cervical canal
How do you get cervical cancer?

Nearly all cases of cervical cancer are caused by an infection with the human papillomavirus (HPV). Other causes can be linked to the risk factors with smoking being of major concern.

The risk factors associated with cervical cancer are:  

  • Infection with the human papillomavirus (HPV)
  • Lack of regular Cervical Screening Tests
  • Screening abnormality or previous cancer diagnosis
  • Age
  • Smoking
  • Weak immune system
  • Exposure to Diethylstilboestrol (DES)

Some research links an increased risk of developing cervical cancer with women who have:

  • Taken contraceptive pills for 5 or more years
  • Have 5 or more children
  • Have had chlamydia
  • Have a family history of cervical cancer
What is the human papillomavirus (HPV)?

HPV is an extremely common group of viruses that can affect both males and females. In fact, up to 80% of people will be infected with at least one type of HPV at some point in their lives.

There are over 100 different strains of HPV, which affect different parts of the body.

Some types of HPV are completely harmless and many have no symptoms. Other types of HPV cause common warts on the hands and feet.

Approximately 40 types of HPV affect the genital area.  Some ‘low risk’ types of HPV (HPV 6 & 11) are responsible for genital warts in both men and women.

The types of HPV that affect the genitals are transmitted via direct skin-to-skin contact with the genital area. This means that it is possible to contract genital HPV without having intercourse.

Because the types of HPV that affect the genitals are transmitted through sexual contact; HPV can lead to other cancers including penile cancer in men, as well as anal cancer and head, neck, throat and mouth cancers in men and women.

You may become aware of HPV if you have a positive Cervical Screening Test result, or if genital warts appear.

Nearly all cases of cervical cancer are caused by an infection resulting from the human papillomavirus (HPV).


To read more about HPV please visit: http://www.hpv.com.au/

How does HPV cause cervical cancer?
After entering the body, HPV will behave in one of two ways: either remaining dormant (inside the body’s cells), or becoming active. It can take many years for the virus to become active and its presence is usually short-lived. Once you have been exposed to a particular strain of HPV, you are unlikely to catch it again, as the body usually becomes immune to that type.

In the most cases, the body’s immune system will clear the virus from the body naturally within 8 to 14 months. If the immune system does not clear a HPV infection, it can cause normal cells in the lining of the cervix to turn abnormal, which in rare cases can develop into cervical cancer. It usually takes 10 to 15 years for HPV to develop into cervical cancer. Most women who contract HPV do not develop cervical cancer.

Fortunately, the HPV vaccine (Gardasil 9®) protects against nine of the main HPV types that cause 90% of cervical cancer.

Does everyone with HPV get cervical cancer?
No. HPV is an extremely common virus that in most cases will remain undetected and clear up naturally. Some strains of HPV cause genital warts. However, HPV will typically remain present in the body without showing any symptoms. Regular cervical screenings can detect the presence of HPV and any abnormalities in the cells of the cervix which may then be treated before becoming cancerous.

What is a cervical abnormality?
There are different types of early cell changes, which are also called epithelial abnormalities. They are characterised as the following:

  • Atypia: The cervical cells have changed slightly. The cell changes may spontaneously regress naturally, but in some cases can worsen. If a cell shows signs of atypia, it doesn’t necessarily mean you have cancer or will get cancer. Atypia can also be caused by infection or irritation.
  • Squamous abnormalities: The squamous cells of the cervix are abnormal. This may be classified as a low-grade or a high-grade abnormality. High-grade abnormalities are pre-cancerous, and although they don’t usually cause symptoms they can sometimes progress to early cervical cancer if they’re not detected and treated appropriately.

These squamous changes are also called Cervical Intraepithelial Neoplasia (CIN) and are graded according to how severe they appear from a biopsy of the tissue. Early changes are categorised as CIN 1 and these will usually disappear without treatment. Further abnormal changes are categorised as CIN 2 or CIN 3.

  • Glandular abnormalities: The glandular cells of the cervix are abnormal. These abnormalities require further assessment, as they may be either pre-cancerous or cancerous.
How will I know if I have HPV?
Approximately four out of five people will contract HPV at some point in their life. Most of these people will not know that they have contracted the virus and in the majority of cases it will clear up naturally. There are around 100 types of HPV. Some of these can cause genital warts. However, the majority, including those that most commonly lead to cervical cancer, do not carry any noticeable symptoms. The most effective way to detect HPV is through regular cervical screenings, 5 yearly or as recommended by your doctor.

Does smoking affect my chances of getting cervical cancer?
Chemicals in cigarette smoke can damage the cells of the cervix and increase the chance of cancer cell development.

Does family history play a part?
If you have an immediate female relative (mother or sister) who has had cervical cancer, you may have an increased chance of also developing cervical cancer.

What is Diethylstilboestrol (DES) exposure?
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.

Are there any signs or symptoms of cervical cancer?
If early cell changes develop into cervical cancer, the most common signs and symptoms that might be present are:

  • vaginal bleeding between periods or after menopause
  • pain during intercourse
  • excessive tiredness
  • lower back pain
  • bleeding after intercourse
  • unusual vaginal discharge
  • leg pain or swelling

These symptoms can also be caused by other more common conditions so please don’t panic if you do experience them. However, see your general practitioner (GP) if you’re worried or if the signs and symptoms are ongoing. If necessary, your GP will refer you for further tests. In many cases cervical cancer does not usually carry any external symptoms until it is in advanced stages, and so the best way to detect changes to the cervix cells is through the recommended 5-yearly Cervical Screening Test.

How common is cervical cancer?

The Australian Institute for Health and Welfare (AIHW) reported that in 2017, 727 Australian women were diagnosed with cervical cancer and 230 women died. This equates to 9 new cases of and 2 deaths from cervical cancer for every 100,000 women. In 2018 1,523,868 screening tests were conducted in women aged 25 – 74 years and of these about 8% were diagnosed as having some abnormality.

Cervical cancer ranks as the 13th most frequent cancer among women in Australia and the 5th most frequent between women from 25-44 years of age. Globally, cervical cancer is the fourth most common cancer affecting women, ranking fourth for both incidence and mortality;

It is believed that over 311,000 women a year worldwide die of cervical cancer. In developing countries where vaccines and screening are usually not available, cervical cancer is one of the leading cancer killers of women.