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Monday, Jan. 5, 2015


Screen for threats

Most women are familiar with an annual visit to their OBGYN – a check-up to manage gynecological health and screen for any potential issues. One of those issues is the concern for cervical cancer, a cancer in which abnormal cells grow in the cervix. 

“In the United States, cervical cancer is the third most common gynecological cancer diagnosed,” Dr. Christopher Snead, hematologist and oncologist with CHRISTUS Health Cancer Treatment Center, said. “It is less common than endometrial [uterine] cancer and ovarian cancer. Annual incidence of cervical cancer in developed nations is around nine out of 100,000 women. Cervical cancer is more common in underdeveloped nations and in lower socioeconomic groups of people.”

While it’s more prevalent in underdeveloped nations, there are some lifestyle and health indicators that make cervical cancer a much more serious threat. 

“Risk factors for cervical cancer include infection with human papilloma virus, which is detected in over 99 percent of cervical cancers,” Snead said. “HPV infection may cause no symptoms but can be detected on Pap smears. Other risk factors include early onset of sexual activity, multiple sexual partners, history of sexually transmitted diseases and immunosuppressive conditions such as HIV and low socioeconomic status. Cigarette smoking increases the risk for squamous cell carcinoma of the cervix.”

Squamous cell carcinoma is the most common type of cervical cancer, according to the American Cancer Society. The other most common form are adenocarcinomas, which is a cancer that forms from the gland cells.

A significant factor in this type of cancer is that early detection is key, as there may be no alarming warning signs pointing to trouble. “Early stage cervical cancer may cause no signs or symptoms,” Snead said. “As cervical cancer progresses, women may have pelvic pain or pressure, abnormal vaginal bleeding or discharge, low back pain, and urinary or bowel problems.”

While there is not a solid determining cause to cervical cancer, there are strong links between its onset and other medical conditions.

“Cervical cancer is usually associated with HPV infection,” Snead said. “There are many strains of HPV. Higher risk HPV includes HPV 16, 18, 31, 33, 45.  HPV infection alone does not necessarily cause the cancer, but it plays a key role in its development.”

The screening for signs of cervical cancer can be done in the annual trip to the doctor where results are carefully examined. 

“Annual gynecologic exams will include Pap smears and testing for HPV,” Snead said. “Large tumors may be visible at the time of exam. Smaller tumors and precancerous conditions may be detected on Pap smears, when the tissue of the cervix is examined under the microscope. Women with abnormal Pap smears may need additional testing such as cervical biopsy. Cervical cancer is diagnosed by detecting cancerous cells on Pap smear or cervical biopsy,” Snead continued. “There are two major types of cervical cancer. The most common type is squamous cell carcinoma, representing two-thirds of cervical cancers.  Adenocarcinoma of the cervix accounts for approximately one-third of cervical cancers.”

Treatment for cervical cancer can vary based on the stage in which the cancer is found, and the procedures range from least to most invasive with follow-up treatments as well. 

“Early stage cervical cancer may be treated locally and may not require a hysterectomy but less invasive cervical ablative techniques,” Snead said. “Some cervical cancers will require surgery such as a hysterectomy. Advanced cervical cancers sometimes cannot be removed in their entirety with surgery. These women are usually treated with radiation with chemotherapy. Sometimes these women can undergo surgery after chemotherapy and radiation. Treatment for metastatic cervical cancer is palliative with chemotherapy, radiation or both.  

“Cervical cancer is responsible for three deaths per 100,000 women each year in the United States,” Snead continued. “Although this seems like the likelihood of dying from cervical cancer is not high, cervical cancer is usually able to be detected at an earlier stage with appropriate screening tests. The earlier cancer is diagnosed, the greater the chance of survival.”

In order to take a proactive approach in their gynecological health, women are encouraged to see their physicians for routine exams on a regular basis. Knowledge is power, and asking the right questions can prove significant, such as if you are specifically being screened for HPV as a part of the annual exam. 

“Women should engage in routine gynecologic exams, which should usually commence after they become sexually active,” Snead said. “Avoiding cigarette smoking can decrease the risk of squamous cell carcinoma. Screening for HPV can identify groups of women who are at higher risk for developing cervical cancer. Promiscuity increases the chance of developing cervical cancer. Compared with one partner, the risk increases twofold with two partners and threefold with six or more partners.”

Knowing the risks and potential risk factors and taking the preventative measures to screen for any possible threats of cancer can mean the difference between a clean bill of health and a cervical cancer diagnosis.


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