Everything you need to know about cervical cancer

Cervical cancer is a disease which affects thousands of women in the UK each year. Renowned consultant gynaecologist and cancer surgeon  Dr Natalia Povolotskaya provides answers to your frequently asked questions about the disease and explains its relationship with HPV.

What is cervical cancer?

Cervical cancer is cancer of the neck of the womb. It is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer mortality in women. Persistent infection with oncogenic human papillomavirus (HPV) is prerequisite in most cervical cancers. However, in recent years HPV‐independent cervical cancers, adenocarcinoma in particular, have been recognised.

Are all cervical cancers related to HPV?

90 - 99% of cervical cancers are HPV related.  Fortunately, 90% of HPV infections resolve spontaneously within 2 years while only about 10% of all HPV infections become persistent. Persistent HPV infections can put the woman at risk of developing precancerous cervical lesions.

The time interval between HPV infection and development of precancerous lesions is 1–10 years, while progression to invasive carcinoma is usually 7 - 10 years

What risk factors are linked to cervical cancer?

The main risk factors for developing cervical cancer are:

•       Persistent Human papillomavirus (HPV) infection

•       Not taking part in cervical screening programme

•       Having untreated high-grade cervical intraepithelial neoplasia (CIN)

•       Tobacco usage/smoking

•       Being Immunodeficient/immunocompromised

If you have an abnormal smear you will need to have a colposcopic assessment of your cervix. A colposcope is a microscope that stays outside your body, but allows a clinician to undertake an assessment and take a biopsy.

What are the most common symptoms of cervical cancer?

Symptoms of cervical cancer are as follows:

•       Unscheduled vaginal bleeding

•       Heavy menstrual bleeding

•       Contact vaginal bleeding ( e.g after sexual intercourse)

•       Vaginal discharge which is watery or malodorous

•       Pain during sexual intercourse

•       Bleeding after menopause

•       Unexplained, persistent pelvic and/or back pain

•       Urinary symptoms

In some cases, cervical cancer does not show any signs.

What is the best treatment for cervical cancer?

Treatment given depends on the stage of cervical cancer. In very early stages, when cancer can be seen only under microscope, an LLETZ procedure may be sufficient. This is a procedure which permits the patient to preserve their fertility.

If fertility preservation is no longer required, a minimal access hysterectomy can be performed. For treatment of organ confined tumours which are relatively small but visible to the human eye, radical hysterectomy is an option.

With regards to tumours that are of higher stage, chemoradiotherapy is the treatment of choice. MRI scans, CT scans and PET-CT scans can all be used to determine the stage of cervical cancer, prior to making a decision regarding the appropriate treatment.

If you are concerned about cervical cancer and would like to book a consultation with Dr Povolotskaya, simply visit her Top Doctors profile today.