Risk factors and causes of cervical

cancer
Doctors cannot always explain why one woman develops
cervical cancer and another does not. However, we do
know that a woman with certain risk factors may be more
likely than others to develop cervical cancer. A risk factor
is something that may increase the chance of developing
a disease.

Studies have found a number of factors that may

increase the risk of cervical cancer. These factors may
act together to increase the risk even more:

Human papillomaviruses (HPVs): HPV infection is the

main risk factor for cervical cancer. HPV is a group of
viruses that can infect the cervix. HPV infections are very
common. These viruses can be passed from person to
person through sexual contact. Most adults have been
infected with HPV at some time in their lives. Some types
of HPV can cause changes to cells in the cervix. These
changes can lead to genital warts, cancer, and other
problems. Doctors may check for HPV even if there are
no warts or other

If a woman has an HPV infection, her doctor can discuss

ways to avoid infecting other people. The Pap test can
detect cell changes in the cervix caused by HPV. (See the
"Screening" section to learn more about the Pap test.)
Treatment of these cell changes can prevent cervical
cancer. There are several treatment methods, including
freezing or burning the infected tissue. Sometimes
medicine also helps.

Cervical and Uterine Cancers

Completely different types of cancer affect different areas
of the womb, or uterus.
The best known is cervical cancer, which affects the
cervix, or neck, of the womb.
Many women, thanks to early detection, find they have
abnormal cell changes in their wombs which cannot be
classed as fully cancerous.

These "pre-cancerous changes" are far easier to treat,

and the number of women presenting with the symptoms
of cervical cancer has fallen over recent years.

However, more common is uterine cancer, in its more

usual form also called endometrial cancer - which affects
the lining of the womb that grows, is shed, and regrows
as part of a woman's monthly cycle.

Symptoms

Samples of cells from different areas around the womb

neck are taken and looked at under a microscope for
signs of abnormality.

If a smear is abnormal, the woman may be asked to take

a repeat smear, or, particularly if there has been more
than one abnormal smear, be sent to a specialist for
further checks.
Once cancer is established however, the most common
symptom is abnormal (ie non-menstrual) bleeding. This
is a sign that the cancer has spread to surrounding
tissue.

Menstrual bleeding may be heavier and last longer.

Abnormal bleeding, particularly after the menopause, can

also be a sign of uterine cancer.

Women with certain symptoms should always consult a

doctor. They are:
any sort of unusual vaginal discharge
pain in the pelvic area
painful or difficult urination
Once there is a suspicion of problems, there are various
techniques used by doctors to try and locate the cause.

The first is a pelvic examination, which can be carried out

by a family doctor, who will check the vagina, womb,
ovaries, bladder and rectum for unusual lumps or
changes.

Doctors may carry out another smear test, or Pap test, to

gather cells to check for cervical cancer.

A technique called colposcopy, which uses a probe to look

in more detail at the cervix, is sometimes used.

The extent of any cancer discovered may be confirmed

by taking a deeper slice of tissue in a biopsy.
However, if uterine cancer is suspected, either a "pipelle
biopsy", in which a thin tube is used to take a small
sample of tissue, or a dilation and curettage (D and C)
may be undertaken. The latter, involves scraping tissue
from the lining of the womb for examination.

Causes
Scientists have identified a virus which they believe may
have some role in the development of cervical cancer.

The human papillomavirus (HPV), is found in most

women who have developed cervical cancer.

However, most women who have the virus never go on to

develop cervical cancer.

Smoking, as in so many other cancers, appears to

increase the risk.

And women with HIV, the virus which causes Aids and
weakens the immune system appear to be more prone.

The risk factors for uterine cancer are slightly more

clearly understood.

In particular, those taking estrogen-only hormone

replacement therapies to alleviate menopausal symptoms
are at higher risk. Most HRT formulations include other
hormones such as progestin which appear to reduce that
risk.

Overweight or obese women are thought to have more

natural estrogen in their bodies - another reason why
they are more vulnerable.

Women who suffer from a condition known as benign

endometrial hyperplasia, in which the lining of the womb
is naturally thicker, also are more likely to develop
endometrial cancer.

Treatments
If caught at their earliest pre-cancerous stage, abnormal
cervical cells can be dealt with simply, using either
freezing or heat to scour the cells from the cervix.

The action of the deep biopsy, called a cone biopsy, can

remove a cervical cancer if it has not spread.

Depending on the spread of the disease, and the age of

the woman, a number of options are available, including
surgery to remove abnormal tissue or the entire womb,
including the cervix.

If there is evidence of spread, then the ovaries and

nearby lymph nodes are sometimes removed as well.

If the cancer has spread beyond the wall of the womb,

then radiotherapy and chemotherapy may be required to
try to clear the disease.

In the case of uterine cancer, it is far more likely that a

hysterectomy will have to be carried out, and the ovaries
may also be taken out.
If it has not spread beyond the endometrium, then
surgery will probably be enough, although other
treatments may follow if there is evidence of spread.

It may be possible for the woman to take HRT following

the operation, although this is only likely if the cancer
has been caught early.

Signs and symptoms of cancer

The signs and symptoms depend upon the body part

affected by the disease. The primary tumor or spread of
tumor to lymph nodes or distant parts of the body may
cause symptoms. In general, cancer has a tendency to
start as a nodule or mass of tissue, which keeps on
growing. The growth rate of cancers is variable, with
some growing very rapidly and others growing slowly.
With further growth, cancers which affect external or
internal body surfaces can form wounds or ulcers, leading
to dirty discharge, bleeding etc.