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Cervical Cancer

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Cervical cancer is a malignancy of the cervix. Worldwide, it is the second most common cancer of women. It may present with vaginal bleeding but symptoms may be absent until the cancer is in advanced stages, which has made cervical cancer the focus of intense screening efforts utilizing the Pap smear. Most scientific studies point to human papillomavirus (HPV) infection is responsible for >90% of the cases of cervical cancer. Treatment is with surgery (including local exicision) in early stages and chemotherapy and radiotherapy in advanced stages of the disease. An effective vaccine for the two most common strains of HPV has recently been licenced (see below).

The early stages of cervical cancer may be completely asymptomatic (Canavan & Doshi, 2000). Vaginal bleeding, contact bleeding or (rarely) a vaginal mass may indicate the presence of malignancy. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere.

The possibility to identify premalignant changes on a cervical smear has made screening the major cause for referral of women with possible cervical neoplasia. In many countries, women are advised to have a regular Pap smear to check for premalignant changes.[1] Recommendations for how often a Pap smear should be done vary from once a year to once every five years. If cervical cancer is detected early, it can be treated without impairing fertility. Consistently abnormal smears may be a reason for further diagnosis despite complete absence of symptoms.

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