Cervical Health

The cervix is part of the internal female reproductive system. Often referred to as the neck of the uterus (womb), the cervix is the narrow, lower part of the uterus that connects to the upper part of 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 (dilating) during childbirth to allow the baby to pass through the vagina)

Two types of cells cover the cervix. Squamous cells are flat, thin cells found in the lower part of the cervix that opens into the vagina. Glandular cells or columnar cells are column-shaped cells that produce cervical mucus and are found higher up in the cervical canal. The ‘transformation zone’ of the cervix is where cells are constantly changing from glandular to squamous cells.

Sometimes cells in the cervix can change. These early cervical cell changes may be precancerous. This means there is an area of abnormal tissue that is not cancer but may lead to cancer and needs to be monitored.  Only some women with precancerous changes of the cervix will develop cervical cancer. Click through to read more about:

Cell changes, also referred to as cervical abnormalities

Diagnostic tests

Cervical cancer begins when abnormal cells in the lining of the cervix grow uncontrollably. It may then spread to other parts of the reproductive system or to other parts of the body.

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

Squamous cell carcinoma –begins in the squamous cells of the cervix. It accounts for around 80% of all cervical cancer cases.

Adenocarcinoma –begins in the glandular/columnar cells of the cervix. This type is less common and is harder to diagnose as it occurs higher up in the cervix.

A small number of cervical cancers contain both squamous cells and glandular cells. These cancers are known as adenosquamous carcinomas or mixed carcinomas. Other rarer types of cancer that can start in the cervix include small cell carcinoma and cervical sarcoma.

Click through to find out more about:

Stages of cervical cancer

Treatment

Almost all cases of cervical cancer are caused by an infection called the human papillomavirus (HPV). HPV is a group of viruses. It is a very common infection with over 100 strains that affect different parts of the body. Approximately 40 strains of HPV which are spread via skin-to-skin contact during sexual activity affect the genital area. 80% of people of all genders will be infected with at least one of these -strains of HPV at some point as a normal part of being sexually active. Any contact with the genital area can transmit HPV, including contact with the mouth, throat and anus.

Most people who contract HPV do not develop cancer. HPV is usually harmless and doesn’t cause symptoms, so most people won’t even know they have it. Most of the time, the virus is cleared quickly by the body’s immune system in a few months. . Occasionally low risk strains can cause genital warts to develop. These are growths on the genital area which are not cancer and can be treated.

If the immune system does not clear an HPV infection, high risk strains of HPV can cause normal cells in the lining of the cervix to turn abnormal (see cervical cell changes), which may eventually develop into cervical cancer. It usually takes 10 to 15 years for cervical cancer to develop.

Because the strains of HPV that affect the genitals are transmitted through sexual contact, long term HPV infection can also lead to other cancers including anal cancer, vaginal and vulvar cancers, penile cancer and oropharyngeal cancers (head, neck, mouth, throat)

Read further about prevention – HPV vaccination and HPV testing/Cervical Screening Tests.

Persistent HPV infection is the biggest risk factor for cervical cancer, however other risk factors include:

Lack of cervical screening tests – Cervical cancer is more common among women who don’t have regular Cervical Screening Tests. Find out more about Cervical Screening Tests.

Smoking – Chemicals in tobacco may damage the cells of the cervix and make cancer more likely to develop. Smoking also makes the immune system less effective in fighting HPV infections. Women who smoke tobacco are about twice as likely as non-smokers to get cervical cancer.

Weak immune system – The immune system helps rid the body of HPV. Women with a weakened immune system have an increased risk of developing cervical cancer.

Age – Women over 35 years old are more likely to develop cervical cancer. Around 70% of cervical cancers are diagnosed in women under 60 years old.

Long term use of contraceptive pills – An increased risk of cervical cancer may occur in women who have HPV and have been taking contraceptive pills for 5 or more years. This risk decreases quickly if you stop using the pill.

Screening abnormality or previous cancer – women who have HPV are at a higher risk of cervical cell changes or abnormalities and cancer. Women who have been diagnosed with cervical cancer in the past are also at a higher risk of developing cervical cancer again.

Having many children ­­- Having 5 or more children may slightly increase the risk of cervical cancer for women who have HPV infection.

Having other sexually transmitted infections (STIs) – STIs such as chlamydia and herpes can increase the risk of cervical cancer.

Exposure to Diethylstilboestrol (DES) – 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.

Cervical cancer does not usually carry any external symptoms until it is in advanced stages, and so the best way to prevent cervical cancer is through Cervical Screening Tests

However, if symptoms occur they may include:

• 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

Please note that these symptoms can also be caused by other more common conditions. It is important to see your doctor if symptoms are ongoing. If necessary, your GP will refer you for further diagnostic tests.

For a complete list of terms relating to cervical health and cervical cancer please see our glossary of terms.

Is cervical cancer hereditary?

As mentioned, the majority of cases of cervical cancer develop from contracting the human papillomavirus. As this is a virus you contract; there is currently little evidence that you are any more predisposed to developing cervical cancer if your mother or grandmother had it.

Have they found a cure for cervical cancer yet?

Currently, there is no cure for cervical cancer. There are effective treatments such as different types of surgery and chemotherapy that can rid the body of cancer completely, as is the case with all types of cancer. Like most forms of cancer, the effectiveness of these treatments are dependent on the stage and type of the cancer.

Does cervical cancer treatment affect women’s ability to have kids?

It depends on the case, the stage of the cancer and what is deemed the most appropriate treatment based on a variety of factors. As each person is different, it is important to discuss this with your healthcare professional.

Can you still get HPV if you are a virgin?

It is unlikely you will contract HPV if you have not had any type of sexual intercourse. However, as HPV is spread through skin to skin contact with the genitals it is possible that other types of sexual contact could spread HPV.

If you have had any sexual contact with the genitals then it increases your risk of contracting HPV.

Can you get HPV from kissing only?

Currently, There is no conclusive evidence that open-mouthed kissing with tongue (French kissing) is capable of transferring an infection.