What Is Cervical Cancer?

What Is Cervical Cancer?

Cervical cancer, affecting about 500,000 people a year, is one of the 5 most common types of cancer in women.

Cervical cancer is a type of cancer that develops in the 'cervix', the neck of the womb. When the layer of cells covering the surface of the cervix turns into abnormal cells, cells that can be called 'precancerous lesions' (CIN) appear. If precancerous lesions are not detected and treated early, they can turn into cervical cancer.

The main agent responsible for this change is the Human Papilloma Virus, known as 'HPV'. HPV is also known as a virus that causes genital warts. This virus is transmitted sexually.

Cervical Cancer Symptoms

Cervical cancer may cause no symptoms in its early stage. However, vaginal bleeding, a feeling of fullness or a mass in the vagina, vaginal discharge and painful intercourse are among the common symptoms. Bleeding can occur during intercourse, or afterwards it appears as spotting with a foul-smelling discharge.

The tumour can spread upwards into the endometrial cavity (the space inside the womb), downwards into the vagina and sideways to the pelvic wall. It can directly invade the bladder and rectum. Depending on this spread, constipation, blood in the urine, urine or faeces passing through the vagina, and dilatation of the ureter or kidney may be seen.

In addition, because of spread to the pelvic wall, leg pain and severe low back and groin pain may occur, and oedema may develop. Distant organ metastases may take the form of extrapelvic lymph node involvement and spread to the liver, lungs and bones. Although cervical cancer is generally seen in middle-aged and older women, it can occur at any age.

Cervical Cancer Risk Factors

The most common cause of cell changes developing in the cervix is HPV infection. The HPV virus settles inside the cells of the cervix after sexual intercourse. Between 50 and 80 percent of women may encounter an HPV infection at some point in their lives. Our immune system clears these within 12-18 months with a 90 percent probability. Having had an HPV infection does not mean that you will get cervical cancer.

The carcinogenic types of HPV infection can cause genetic changes in cervical cells and lead to cancerous changes. This process takes about 10-15 years. Therefore, through follow-up and screening methods, physicians can detect and prevent cancer before it develops.

Cervical Cancer Diagnostic Methods

The first finding is an abnormal PAP smear result in patients who undergo a PAP smear test during routine gynaecological examination and follow-up.

After an abnormal PAP smear test, depending on the result, the PAP smear test may be repeated after a while, or the cervix is imaged with a device called a colposcope. A biopsy can also be performed during colposcopy if deemed necessary.

In addition, PAP smear is also used in regular check-ups carried out to prevent cervical cancer and to enable early diagnosis. The test called HPV-DNA is also among the methods that can be used in screening programmes together with the PAP smear or on its own.

Under normal circumstances, the likelihood of HPV in women aged 20-30 is 30-50 percent. Therefore, when an HPV test is performed in this group, the values are positive in most patients and the HPV test loses its meaning.

From the age of 25/30, the preferred method is an HPV test every 5 years; alternatives are a co-test every 5 years or a smear every 3 years. You can look at the HPV PCR test performed in our laboratory.

Ways to Prevent Cervical Cancer

1. The risk of HPV infection can be minimised with a vaccine. The HPV vaccine is a safe and effective way of protecting against cancers caused by the virus.
2. National and international health organisations recommend that all boys and girls aged 9-14 receive two or three doses of the HPV vaccine to protect against HPV-related cancers. The vaccine is given to girls and boys at the age of 9-14; for those not vaccinated before, it can be given up to the age of 26, and at the age of 27-45 by shared decision with a doctor.
3. Cervical cancer can be diagnosed early through routine screening tests such as smear and HPV tests performed on women aged 21-65.
4. To protect against cervical cancer, if you are sexually active you should use a condom at every sexual contact. Although this reduces the risk of the virus, HPV can be transmitted to areas not covered by the condom; therefore condoms may not provide complete protection against HPV. Mutual monogamy reduces the likelihood of transmitting the virus.