- According to the WHO data, after breast, colorectal and lung cancer, cervical is the fourth most common cancer in women worldwide.
- Though every woman is at risk for cervical cancer, it occurs most often in women over the age of 30.
- Regular cervical cancer screening reduces the incidence of cervical cancer and the number of deaths caused from cervical cancer dramatically due to it’s ability to detect disease and allow for treatment before it progresses.
- High-risk strains of the human papillomaviruses (HPV), an extremely common virus transmitted through intimate skin-to-skin contact, are linked to the majority of all cervical cancer cases (99%).
- HPV is highly contagious and high-risk strains do not have symptoms. There is not treatment for HPV, typically the body will clear the virus on its own. In some instances it can go dormant and reappear years or even decades later.
Source: WHO
Risk factors of cervical cancer
Several risk factors for cervical cancer can be avoided, but many cannot. Smoking and inheriting certain genes, for example, are both risk factors, but only smoking can be avoided. Avoiding risk factors and increasing protective factors may reduce your risk, but it does not eliminate the possibility of developing cancer.
The risk of getting HPV virus is higher for women who are sexually active, those who do not use protection and frequently change partners. In women who are infected with HPV, other risk factors add to the increased risk of cervical cancer, such as giving birth to many children or using oral contraceptives for a long time.
Source: cancer.gov
Screening and diagnosing methods
Cervical cancer normally takes years to develop. Prior to it developing, the tissue will be abnormal. This cellular change is called dysplasia or cervical intraepithelial neoplasia (CIN). The presence of abnormal cells doesn’t mean cancer will form, often the cells may return to normal. In order to determine and track the health of cervical tissue, women should be regularly screened for cervical cancer. Screening is vital to identify and determine if and when abnormal tissue should be removed in order to stop cancer from developing. Cervical precaner and cancer often have no symptoms.Once symptoms do appear the cancer cells may have already spread. Treatment of precancer or cancer is less invasive and cheaper the earlier it is diagnosed.
Source: cancer.gov
PAP TEST
A Pap test is commonly used to screen for cervical cancer. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that’s at the top of your vagina. Pap test is a procedure that uses a small brush or spatula to collect cells from the surface of the cervix. The samples of cells are placed into a liquid solution or smeared onto a microscope slide. The samples are then to a laboratory, where a cytologist views them under a microscope to see if there are abnormal cells present. Pap test was first introduced into the medical protocol after the 2nd WW. The dramatic decrease in cervical cancer incidence and mortality is attributed to this screening test. Though the success of this test has saved many lives, it’s accuracy in correctly identifying if disease is present is seen as moderate resulting in false positives. Because of this a physician may perform additional tests in order to determine a more accurate diagnosis.
COLPOSCOPY AND BIOPSY
Colposcopy is a procedure to closely examine the surface of the cervix after an abnormal screening test. During colposcopy, the physician will apply acetic acid (vinegar) to the cervix and then use a colposcope, a specialized instrument that magnifies the view of the cervix, to see if any abnormal areas reacted to the acetic acid. Sometimes an iodine solution will also be applied and the physician may use different light filters on the colposcope to aid in identifying signs of abnormal tissue. If abnormal areas are seen, the physician will take a biopsy from each location. For a cervical biopsy, a specialized instrument is used to remove a sample from the abnormal area. The sample(s) are then sent to a laboratory for a pathologist to examine and provide a diagnosis. Some discomfort and pain 24 to 48 hours after the biopsy procedure is normal as is some spotting/bleeding and discharge as the cervix heals. Usually, it takes some weeks until the results of the biopsy become available.
HPV TEST
The sample for an HPV test uses a small brush or spatula to collect cells from the surface of the cervix. The sample of cells is then placed into a liquid solution and sent to a lab. There the sample is analyzed using automated laboratory equipment to determine if HPV is present in the sample. Most HPV tests will further identify what strains of HPV are present. This test method is very accurate in correctly identifying if HPV is present. The downsides to this method are that it can be costly and it only identifies if an infection is present not if precancerous cells are present. If a patient is found to be HPV positive, her physician will most likely order another screening test to determine if the abnormal tissue is present.
LuViva
The LuViva scans the cervix with light to determine if the physical and chemical indicators of abnormal tissue are present within 3 to 5 mm of its surface. The LuViva method is considered a non-invasive method because no tissue samples are collected/removed, additionally, nothing is applied to the cervix. Since the device is a test and laboratory, the analysis of the data collected during the scan occurs in real-time and after the scan provides the physician with its result. The time from the beginning of the scan to receiving the result is a little over one minute. Using this information the physician can immediately decide on the next step in care for their patient. In clinical trials, LuViva’s accuracy in correctly identifying if the disease is present was found to be higher than the Pap test.
Current protocol for treatment
Treatments for cervical cancer are determined by its stage and also by the availability of technologies in a country. In general, the most common forms of treatment are:
Surgery
Removing cancer in an operation is sometimes used to treat cervical cancer.
Radiation therapy
A standard cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
Chemotherapy
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Depending on the type and stage of cancer, the drugs can be either taken by mouth / injected into a vein (systemic chemotherapy) or can be placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the (regional chemotherapy).
Targeted therapy
A type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. I.e.: monoclonal antibody therapy.
Immunotherapy, biotherapy, or biological therapy
A treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer.
Good to know
HPV can lie dormant for years
Although HPV virus usually heals on its own, in certain cases it remains dormant in the body for years and can cause cancer decades later. Cervical cancer caused by HPV may take 10 to 20 years or more to develop.
HPV is more common that you’d think
It has been estimated that more than 80% of sexually active women and men will acquire at least one HPV infection by the age of 45 years. However, most of them will be transient infections without any clinical impact.
You may get HPV even using condom
HPV can reside on the skin in and around the entire vaginal area, so a condom won’t completely protect you. HPV can be transmitted through any type of sexual contact, including touching, as well as oral, vaginal, and anal sex.
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