Cervical Cancer: Symptoms, Screening, and Prevention
Cervical cancer is cancer that begins in the cervix, which is at the bottom of the uterus (womb). During pregnancy, the cervix behaves as a gatekeeper of sorts and helps hold the baby inside. About 11,500 new cases of cervical cancer are diagnosed in the United States each year, according to the Centers for Disease Control and Prevention (CDC). About 4,000 women die of this cancer annually.
Rachel C. Sisodia, MD, reviews cervical cancer risk factors, symptoms, and how the HPV vaccine can help prevent this cancer. Dr. Sisodia is the chief quality officer of Mass General Brigham and a gynecologic oncologist and surgeon who cares for patients at Mass General Cancer Center.
Signs and symptoms of cervical cancer
Most people with cervical cancer are asymptomatic, meaning they don’t have any obvious symptoms.
“Cervical cancer is dangerous. You can’t see your cervix, and it’s hard to feel your cervix,” explains Dr. Sisodia. “You could be developing pre-cancerous cells or even a cancer and not know it’s there. This highlights how important it is to see your primary care provider (PCP) or OB/GYN for regular care.”
Early symptoms of cervical cancer
Most cervical cancers don’t cause symptoms. People who do experience early symptoms of cervical cancer often notice bleeding or new pain during sex.
Advanced cervical cancer symptoms
Advanced symptoms can include, but aren’t limited to:
- Pelvic pressure or fullness
- Increased fatigue
- Blood in your urine
- Constipation
- Loss of bladder control or difficulty with urination
What causes cervical cancer?
The human papillomavirus (HPV) causes more than 95% of cervical cancers. HPV is a common sexually transmitted infection (STI) that can be passed from one person to another during sex.
“One of the first things I always tell my patients is almost everyone who has ever been sexually active has been exposed to HPV,” says Dr. Sisodia. "There's no stigma in it. There's no shame in it. Full stop."
HPV can clear up over time, but some people continue to be HPV positive. Over time, cells in their cervix can become abnormal. In a small number of people, this leads to cancer.
Cervical cancer risk factors
Anyone with a cervix at any age is at risk for cervical cancer. Smokers and people with compromised immune systems also have an increased likelihood of cervical cancer.
Being sexually active does increase your risk for HPV, but you don't need to be currently sexually active to get HPV or cervical cancer.
What is cervical cancer screening?
Routine health screenings help doctors detect cancer earlier, when it’s easier for them to treat. Screening for cervical cancer includes HPV tests and pap tests (also known as pap smears).
Doctors recommend patients have regular HPV tests and pap smears starting at age 21 so that your doctor can check you for cervical cancer. It's also important to note that some rare cases of cervical cancer are not caused by HPV but overwhelmingly, the majority are.
Cervical cancer treatment
The best cervical cancer treatment depends on how far a person’s cancer has progressed.
Pre-cancer treatment
If you have pre-cancer of the cervix or cervical dysplasia, your doctor can perform an in-office procedure that's quick and relatively pain-free.
Early-stage cervical cancer
Unfortunately, surgery for early-stage cervical cancer gets aggressive quickly. Radical hysterectomy — removing the cervix, uterus, and surrounding tissues — is the most common treatment for cervical cancer in its early stage.
"We've made amazing advances in the ability to retain fertility," explains Dr. Sisodia. "Even if you have cervical cancer, many new techniques can help build your family if that's what you want."
Advanced cervical cancer
More advanced cancers tend to be harder for doctors to cure and are almost always treated with a combination of chemotherapy and radiation therapies.
What is the HPV vaccine for cervical cancer prevention?
