Sexual Health and Wellness

CERVICAL CANCER

Features In general early cervical cancer doesn’t show/produce any signs or symptoms. That is why it is important to go for yearly examinations (PAP SMEAR). As the cancer progresses, the following cervical cancer signs and symptoms may appear:

  • Vaginal bleeding after intercourse, between periods or after menopause;
  • Watery, bloody vaginal discharge that may be heavy and have an offensive odour;
  • Pelvic pain or pain during intercourse.

Epidemiology Worldwide, cervical cancer is the fifth most deadly cancer in women. It affects about 16 out of a 100 000 women per year and kills about 9 women out of a 100 000 per year. Worldwide it is estimated that there are 473 000 cases of cervical cancer, and 253 500 deaths per year. In South Africa it is the second most common cancer affecting women. According to CANSA, approximately one in every 35 women will, within their lifetime, develop this form of cancer. Cervical cancer is one of the most common cancers that affect a woman’s reproductive organs. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cases of cervical cancer. When exposed to HPV, a woman’s immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years before it eventually converts some cells on the surface of the cervix into cancer cells. Half of cervical cancer cases occur in women between ages 35 and 55. Thanks largely to Pap test screening, the death rate from cervical cancer has decreased greatly over the last 50 years. Still, an estimated 6 700 South African women develop cervical cancer every year. Causes Cervical cancer begins with abnormal changes in the cervical tissue. The risk of developing these abnormal changes has been associated with certain factors, including previous infection with human papillomavirus (HPV), early sexual contact, multiple sexual partners, cigarette smoking, and taking oral contraceptives (birth control pills). Forms of HPV, a virus whose different types cause skin warts, genital warts (link to Genital Warts), and other abnormal skin and body surface disorders, have been shown to lead to many of the changes in cervical cells that may eventually lead to cancer. Genetic material that comes from certain forms of HPV has been found in cervical tissues that show cancerous or precancerous changes. In addition, women who have been diagnosed with HPV are more likely to develop a cervical cancer that has genetic material matching the strain of virus that caused the infection. These findings demonstrate a strong link between the virus and cervical cancer. Because HPV can be transmitted by sexual contact, early sexual contact and having multiple sexual partners have been identified as strong risk factors for the development of cervical lesions that may progress to cancer. Cigarette smoking is another risk factor for the development of cervical cancer. The chemicals in cigarette smoke interact with the cells of the cervix, causing precancerous changes that may over time progress to cancer. Oral contraceptives (“the pill”) may increase the risk for cervical cancer, especially in women who use oral contraceptives for longer than 5 years.