Cervical Cancer

Group 4

Introduction

Cervical Cancer is the second most common cancer in women

worldwide, with 10, 370 women expected to be diagnosed with invasive
cervical cancer in 2005.

The cervix is the lower part of the uterus and is divided into two major,
contiguous parts: the endocervix and the exocervix. Squamous epithelial
cells line the outside surface of the cervix, and columnar epithelial cells
line the rest of the cervix and the uterus.

The area where the columnar epithelium of the endocervix joins the
squamous epithelium of the exocervix is called the squamocolumnar
junction, often referred to as the transformation zone.

Cervical cancer begins with a neoplastic alterations of the

squamocolumnar junction. Abnormal cells can progress to involve the
full thickness of the epithelium and invade the stromal tissue of the
cervix.

Cervical cancer develops over a period of 2 to 3 decades. Lesions are

usually low grade in nature during adolescence.

Risk Factors
GENERAL

Pregnancy:Women who have had three or more full-term pregnancies, or who had
their first full-term pregnancy before age 17, are twice as likely to get cervical cancer.

GENETICS

Family history:Women with a sister or mother who had cervical cancer are two to
three times more likely to develop cervical cancer.

Race/Ethnicity: Hispanics women

Age: 40-50 usually but older women are still at risk

LIFESTYLE

Sexual history:Certain types of sexual behavior are considered risk factors for
cervical cancer and HPV infection. These include: sex before age 18, sex with multiple
partners and sex with someone who has had multiple partners. Studies also show a
link between chlamydia infection and cervical cancer.

Smoking:A woman who smokes doubles her risk of cervical cancer.

Oral contraceptive use:Women who take oral contraceptives for more than five
years have an increased risk of cervical cancer, but this risk returns to normal within
a few years after the pills are stopped.

Risk Factors(Contd)
Weakened immune system:

In most people with healthy immune systems, the HPV virus clears itself from the body within 1218 months. However, people with HIV or other health conditions or who take medications that limit
the bodys ability to fight off infection have a higher risk of developing cervical cancer.

Diethylstilbestrol (DES):

Women whose mothers took DES, a drug given to some women to prevent miscarriage between
1940 and 1971, have a higher risk of developing cervical cancer.

Human Papilloma Virus

Though HPV causes cancer, having HPV does not mean you will get cancer. The majority of women
who contract HPV clear the virus or have treatment so the abnormal cells are removed. HPV is a
skin infection, spread through skin-to-skin contact with a person who has the virus. Additional
facts about HPV:

There are more than 100 types of HPV, 30-40 of which are sexually transmitted.
Of these, at least 15 are high-risk HPV strains that can cause cervical cancer. The others cause no
symptoms or genital warts.
Up to 80 percent of women will contract HPV in their lifetime. Men get HPV, too, but there is no test
for them.
A healthy immune system will usually clear the HPV virus before there is a symptom, including the
high-risk types of HPV.
Only a small percentage of women with high-risk HPV develop cervical cancer.

Risk Factors (Contd)

Immunosuppression

Human immunodeficiency virus (HIV), the virus that causes AIDS, damages the immune system
and puts women at higher risk for HPV infections. This might explain why women with AIDS have
a higher risk for cervical cancer. The immune system is important in destroying cancer cells and
slowing their growth and spread. In women with HIV, a cervical pre-cancer might develop into an
invasive cancer faster than it normally would. Another group of women at risk of cervical cancer
are those taking drugs to suppress their immune response, such as those being treated for an
autoimmune disease (in which the immune system sees the body's own tissues as foreign and
attacks them, as it would a germ) or those who have had an organ transplant.

A diet low in fruits and vegetables

Women whose diets dont include enough fruits and vegetables may be at increased risk for
cervical cancer.

Being younger than 17 at your first full-term pregnancy

Women who were younger than 17 years when they had their first full-term pregnancy are
almost 2 times more likely to get cervical cancer later in life than women who waited to get
pregnant until they were 25 years or older.

Poverty/ Socioeconomic status

Poverty is also a risk factor for cervical cancer. Many low-income women do not have ready
access to adequate health care services, including Pap tests. This means they may not get
screened or treated for cervical pre-cancers

Signs and Symptoms

Women with early cervical cancers and pre-cancers usually have no
symptoms. Symptoms often do not begin until a pre-cancer becomes a true
invasive cancer and grows into nearby tissue. When this happens, the most
common symptoms are:

Abnormal vaginal bleeding, such as bleeding after sex (vaginal

intercourse), bleeding after menopause, bleeding and spotting between
periods, and having longer or heavier (menstrual) periods than usual.
Bleeding after douching, or after a pelvic exam is a common symptom of
cervical cancer but not pre-cancer.

An unusual discharge from the vagina the discharge may contain

some blood and may occur between your periods or after menopause.

Pain during sex (vaginal intercourse).

Advanced cervical cancer

Signs and Symptoms(Contd)

If the cancer spreads out of your cervix and into surrounding tissue and
organs, it can trigger a range of other symptoms, including:

constipation

blood in your urine (hematuria)

loss of bladder control (urinary incontinence)

bone pain

swelling of one of your legs

severe pain in your side or back caused by swelling in your kidneys,

related to acondition calledhydronephrosis

changes to your bladder and bowel habits

loss of appetite

weight loss

tiredness and a lack of energy