Objectives
Cervical cancer ranks first in women's cancer incidence in Korea, and fourth most frequent in women worldwide. By age group, those in their 40s accounted for 24.7%, followed by those in their 50s with 23.3% and those in their 30s with 18.3%. The incidence of cervical cancer for women in their 20s is relatively low compared to other ages. However, the average annual increase in the number of younger patients is the highest at 3.6%. You can't rest assured just because you’re young. Cervical cancer is something we should be all be wary of now.
The Dark Shadow Targeting Your Uterus
Causes
Human Papillomavirus (HPV) is a primary cause of most cases of cervical cancer. HPV is a common sexually transmitted infection and anyone who is sexually active can be infected. There are about 80 varieties of HPV and HPV 16 and 18 are categorized as high-risk types as they can cause cervical cancer.
Q. 🙋♀️ If infected with HPV, does that mean you would definitely get cervical cancer?
A. 🙅♀️ No. Low-risk HPV strains mostly don’t cause cancer and even most women who are infected with high-risk HPV don’t experience symptoms or the infection clears up on its own. Even if you're infected with HPV, it does not always lead to cervical cancer.
Environmental Factors
The most common cause of cervical cancer is HPV but there are also various environmental factors that can contribute to it.
- Early sexual debut
- Number of sexual partners
- Frequent childbirth
- Smoking
- Long-term use of oral contraceptives
There is a possibility of cancer due to genetic modifications caused by smoking and a decline in immunity function due to smoking increases the possibility of malignant transformation. There was also research on the long-term use of oral contraceptives which can increase the risks of cervical cancer by 1.2 to 1.5 times.
Prevention
The HPV vaccine can help prevent cervical cancer. But it’s not 100%. Vaccines were manufactured to prevent some types of high-risk HPVs including types 16 and 18, but they can only prevent cancers related to the HPV types the vaccine protects against. It can prevent about 70-90% of cancer cases that are related to high-risk HPVs but cannot prevent the the other 10-30% of causes for cervical cancer. Therefore, you should still get a cervical cancer screening regularly.
✋ Precautions for Cervical Cancer Screening
- Avoid getting the screening during menstruation
- Get screened between 10 to 20 days from the start of menstruation
- But get tested regardless of bleeding if you have symptoms such as irregular bleeding or bad smelling vaginal discharge
- Avoid intercourse, using tampons, vaginal cleansers, vaginal tablets, lubricants, and spermicides within 48 hours of getting screened
Symptoms
Cervical cancer generally has different signs and symptoms depending on its progression.
Early
- Often has no symptoms
- Irregular vaginal bleeding, continuous vaginal bleeding, or bleeding after intercourse
Mid-stage
- Bleeding after urination
- Blood in the urine
More-advanced cervical cancer
- Weight loss
- Bloody vaginal discharge with a foul odor
- Severe pelvic pain, backache
Treatments
Treatment for cervical cancer includes surgery, radiation therapy, and chemotherapy. Treatment is determined based on the stage of cancer, size of cancer, age, condition of the body, and whether you have a desire to be pregnant in the future.
✔ The Progression of Cervical Cancer
Stage 0 Cancer cells are only in the surface layer of cells (also called “carcinoma in situ,” have not spread to other areas, and is not considered to be cancer)
Stage 1 Cancer has grown into the cervix
Stage 2 Cancer has spread slightly beyond the cervix
Stage 3 Cancer has spread to the walls of your pelvis beyond the cervix
Stage 4 Cancer has spread to nearby organs or other parts of your body
Side Effects of Treatment
Complications from Surgery
- Acute: Complications may include hemorrhaging, intestinal obstruction, vascular injury, rectal rupture, pneumonia, and pulmonary embolism but acute complications are very rare due to the advancement of surgeries
- Chronic: Most common is poor function of the bladder or rectum
Complications from Radiation
- Acute: Temporary increase in bowel movement, diarrhea, and symptoms similar to general cystitis due to mucosal damage
- Chronic: Bloody stool and urine due to intestinal obstruction and mucosal damage of the rectum and bladder
Recurrence
Generally, 5-20% of stages 1 and 2 cervical cancer patients relapse, 50% of patients relapse within one year after the first treatment, and the other 50% of patients relapse within three years. Even if relapsed with cervical cancer, 20-25% make a full recovery when detected early and getting appropriate treatment. Therefore you should remember to get your routine screening.
Summary
- Make sure to get vaccinated as HPV vaccines can prevent about 70-90% of cervical cancers caused by high-risk HPV infection.
- Routinely get screened as there are cervical cancers that cannot be prevented by the vaccine.
