Cervical cancer

Cervical cancer occurs when abnormal cells in the cervix grow uncontrollably. Around 200 Queensland women and people with a cervix are diagnosed with this cancer each year, most commonly after age 30, though it can develop at any age.

There are two main types of cervical cancer:

• Squamous cell carcinoma: The most common type of cervical cancer, making up 70% of cases
• Adenocarcinoma: A less common type that starts in the glandular cells of the cervix, and is harder to detect due to its higher location in the cervix.

Cervical cancer typically begins in the cervix’s transformation zone and can spread to surrounding tissues like the vagina, or to other parts of the body such as lymph nodes, lungs, or liver.

Almost all cervical cancer cases are caused by human papillomavirus (HPV), a common infection that affects the surface of different areas of the body including the cervix, vagina and skin.

Other factors that can increase risk of cervical cancer include:

• Smoking and passive smoking: Chemicals in tobacco smoke, including second hand smoke, can damage cervical cells, making it harder for the body to clear the HPV infection.
• Long-term oral contraceptive use: Taking the pill for 5+ years increases cervical cancer risk in people with HPV, although it can help protect against other cancers like uterine cancer and ovarian cancer. If you’re concerned, it can help to talk about this with your doctor.
• Weakened immune system: Since the immune system helps fight HPV, people with compromised immunity face higher risk and may need more frequent screening. This includes those with HIV or taking immunosuppressive medications. Ask your doctor if this applies to you, and how often you should have a screening test.
• Exposure to diethylstilboestrol (DES) – DES is a manufactured form of the female hormone oestrogen. DES was prescribed to pregnant women from the 1940s to the early 1970s to prevent miscarriage. Studies have shown that women exposed to DES because their mother took it when she was pregnant have a small but increased risk of developing a clear cell adenocarcinoma, a rare type of cervical cancer.

To reduce your risk of cervical cancer, Cancer Council Queensland recommends all women and people with a cervix get the HPV vaccine (sometimes referred to as the cervical cancer vaccine) and participate in cervical cancer screening tests every five years, if you’re 25 to 74 years old.

There are usually no symptoms in the early stages of cervical cancer. The only way to know if there are abnormal cells in the cervix that could develop into cancer is to have a cervical cancer screening test.

If they do occur, symptoms of cervical cancer can include:

• Vaginal bleeding between periods, after menopause or during or after sexual intercourse
• Pelvic pain
• Pain during sexual intercourse
• An unusual vaginal discharge
• Heavier periods or periods that last longer than usual.

If you’re concerned, or the symptoms are ongoing, see your GP. The signs of cervical cancer can also be caused by other factors or conditions, but it’s important to rule out cervical cancer early by taking a cervical cancer screening test. Anyone with a cervix should make sure they are up to date with their cervical cancer screening tests, regardless of gender identity or sexual orientation.

The Australian Government recommends all women or anyone with a cervix aged between 25 and 74 years participate in the National Cervical Screening Program.

If your screening test results suggest that you have a higher risk of developing cervical cancer, or if you have symptoms of cancer, you will be referred to a specialist for tests to confirm the diagnosis of precancerous changes or cervical cancer.

Some tests allow your doctor to see the tissue in your cervix and surrounding areas more clearly. Other tests tell your doctor about your general health and whether cancer has spread. You probably won’t need to have all the tests listed here.

You may have some or all the following tests:

• Cervical cancer screening test – will detect cancer-causing types of HPV in a sample of cells taken from the cervix.
• Colposcopy – is a way of looking closely at the cervix to help see where abnormal or changed cells are and what they look like.
• Biopsy – is when the doctor removes some tissue from the surface of the cervix and sends it to a laboratory for examination. A biopsy may be done during a colposcopy.
• Large loop excision of the transformation zone (LLETZ) – this is the most common way of removing cervical tissue for examination and treating precancerous changes of the cervix.
• Cone Biopsy – is used when there are abnormal cells found in the cervical canal, when early-stage cancer is suspected or for women needing a larger incision.
• Laser surgery – this procedure uses a laser beam in place of a knife to remove the abnormal cells or pieces of tissue for further study.

Further tests:

• Blood test – to check your general health and how well your kidneys and liver are working.
• CT scan – uses x-rays to take pictures of the inside of your body and compiles them into a detailed three-dimensional picture.
• MRI scan – uses a powerful magnet and radio waves to build up detailed cross-sectional pictures of the inside of your body.
• PET Scan – injection with a glucose solution containing some radioactive material.
• Examination under anaesthetic – the doctor checks whether cancer has spread by examining your cervix, vagina, uterus, bladder and rectum.

Waiting for test results can be a stressful time. It may help to talk to a friend or family member, a healthcare professional, or call Cancer Council Queensland on 13 11 20.

The most common treatment for cervical cancer is surgery and/or a combination of chemotherapy and radiation therapy. When cervical cancer has spread beyond the cervix, targeted therapy may also be used.

Your medical team will recommend the best treatment for you based on:

When we talk about prognosis, we’re talking about the likely or expected outcome of the disease, although it’s important to remember that not even an expert can predict the exact way a disease will progress.

In general, the earlier cervical cancer is diagnosed and treated, the better the outcome. Most early-stage cervical cancers have a good prognosis with high survival rates.

To work out your prognosis, your doctor will consider:

• Your test results
• The type of cervical cancer you have
• The size of cancer and how far it has grown into other tissue
• Whether cancer has spread to the lymph nodes
• Other factors such as your age, fitness and overall health.

We understand how challenging and stressful it can be to discuss your prognosis and think about the future. It may help to talk with family and friends. If you need more information, practical advice, or emotional support, we are here to help. Call our team on Cancer Council 13 11 20.