cervical cancer
Meaning of cervical cancer: Years usually pass between the first abnormal cells and an invasive tumor, and that long window is what screening exploits.
Definition of cervical cancer
Cervical cancer is a malignant tumor arising in the cervix, the narrow lower part of the uterus that opens into the vagina. Nearly all cases follow a persistent infection with certain high-risk types of human papillomavirus, a very common virus passed on through intimate contact. Most are squamous cell carcinomas arising from the surface lining, with adenocarcinoma the next most common form.
How does the virus lead to cancer?
Most infections with human papillomavirus clear on their own within a couple of years and cause nothing at all. Cancer follows the minority that persist, and only with certain high-risk types. Two viral proteins made by those types disable the proteins a cell uses to pause division and repair damage, so genetic errors accumulate instead of being corrected. The first visible result is not a tumor but a change in the surface lining of the cervix, graded by how much of the layer's thickness contains abnormal cells. Low-grade changes frequently regress without treatment. Higher-grade changes are more likely to persist, and only after years does a proportion break through the underlying membrane and become invasive. Vaccination against the high-risk types prevents the infections responsible for most cases, and works before exposure rather than against an infection already present.
What does screening look for?
| Test | What it examines | What an abnormal result means |
|---|---|---|
| Pap test | Cells brushed from the cervix, viewed under a microscope | Abnormal-looking cells are present and need further assessment |
| HPV test | The same sample checked for high-risk viral types | A high-risk type is present, not that cancer is |
| Colposcopy | The cervix under magnification after a solution highlights abnormal areas | Specific areas are identified for biopsy |
Screening is unusual in aiming at a precancerous stage rather than at early cancer, which is why it can prevent the disease rather than only catch it sooner. Screening intervals and starting ages are set by guidelines that are periodically revised.
What symptoms appear, and when?
Early disease, including stage I cervical cancer, commonly causes nothing noticeable and is found through screening. When symptoms do appear they can include bleeding between periods, after intercourse or after menopause, watery or foul-smelling discharge, pain during sex, and pelvic or lower back pain. Every one of these has far more common and entirely unrelated explanations, which is why symptoms are a poor substitute for screening rather than an alternative to it.
Used in a sentence
Regular Pap testing was continued as part of the patient's ongoing screening for cervical cancer.
Good to know
An abnormal Pap test result indicates a finding that requires further evaluation and does not, by itself, mean that cervical cancer is present, since many abnormal results reflect precancerous changes or unrelated causes.
Word origin
Where “cervical cancer” comes from
Cervical derives from Latin cervix, cervicis, meaning neck, referring to the neck-like structure connecting the uterus to the vagina.