Condition Center: Cervical Cancer

This informational guide, part of POPSUGAR’s Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Editor’s Note: We at POPSUGAR recognize that people of many genders and identities have a cervix, not just those who are women. For this particular story, we interviewed sources who generally referred to people with cervixes as women.

Cervical cancer is the fourth-most common type of cancer in women and those assigned female at birth (AFAB) around the world, with over 13,000 new cases diagnosed each year in the U.S. alone, according to the CDC. The condition has garnered tons of attention lately after the passing of beauty influencer Jessica Pettway, 36, who had stage 3 cervical cancer and was originally misdiagnosed with fibroids.

Part of a group of gynecologic cancers (any cancer affecting the female reproductive system), cervical cancer is most often diagnosed between the ages of 35 and 44, says Bhavana Pothuri, MD, a gynecologic oncologist at the NYU Langone Perlmutter Cancer Center.

While the statistics around cervical cancer can be intimidating, many types are preventable with early detection via screening and HPV vaccination, according to the CDC. Here, Dr. Pothuri explains what to know about preventing the condition – as well as early symptoms to keep an eye out for and the latest treatment options.

Understanding Cervical Cancer

Cervical cancer occurs when malignant cells form in the tissues of the cervix, which is the “muscular, tunnel-like organ” that connects your uterus and vagina, according to the Cleveland Clinic. The two most common types of cervical cancer are:

• Squamous cell carcinoma: malignant cells form on the face or outer portion of the cervix. According to the American Cancer Society, about 9 out of 10 cervical cancers are classified as squamous cell carcinomas.
• Adenocarcinoma: malignant cells form in the glandular cells in the upper cervix.

Early cervical cancer often does not show symptoms, Dr. Pothuri says, though it can be caught through screenings. When early-stage cervical cancer symptoms do occur (which again is rare), per the American Cancer Society, they may include:

• Vaginal bleeding after sexual intercourse, after menopause, or between periods
• Periods that are heavier or longer than normal
• Foul-smelling and watery vaginal discharge that may contain blood
• Pelvic pain or pain during sex

Later-stage symptoms of cervical cancer may include:

• Difficult or painful bowel movements
• Rectal bleeding during bowel movements
• Difficult or painful urination
• Back pain or back ache
• Pain radiating down one’s leg
• Swelling legs
• Abdominal pain
• Feelings of tiredness and fatigue

Causes and Risk Factors For Cervical Cancer

According to the CDC, nearly all cervical cancer is caused by human papilloma virus (aka HPV). HPV is a sexually-transmitted infection (STI) and is spread through spread through vaginal, anal, or oral sex and intimate skin-to-skin contact. It’s also highly common, likely to affect almost everyone at some point in their life – thought most infections go away on their own within two years. Approximately 80-90 percent of us will have HPV in our lifetime if we’ve had any sexual contact, but very few of us will have cervical cancer.

There are over 100 strains of HPV; of those, about 14 are considered high risk, according to the National Cancer Institute. If you become infected with a high-risk strain, and your immune system doesn’t resolve the infection, it may cause precancerous cells to form (i.e. those that, if left alone, may turn into cancer). These mutated cells may become cancerous if they aren’t detected (which is possible through Pap tests) and removed. HPV can lead to multiple types of cancer, including cancer of the cervix, anus, penis, vagina, vulva, and oropharynx (the back of the mouth and top of the throat).

While HPV causes nearly all cases of cervical cancer, other factors can increase your risk. According to the American Cancer Society, these include:

• Smoking
• Having a weakened immune system such as through HIV/AIDS or prior organ transplants
• Factors related to sexual history, such as becoming sexually active at a young age, having many sexual partners, or having a partner who is high risk can increase your risk. The younger you are and the more partners you have, the higher the odds of exposure. But it’s also worth noting that it only takes one infected partner to expose you to HPV
• Past or current chlamydia infection
• Having multiple full-term pregnancies. Experts aren’t sure why; it could be that hormonal changes that take place during pregnancy put people at greater risk, or because people who have multiple pregnancies may be more sexually active and therefore more likely to be exposed to HPV
• Experiencing a first full-term pregnancy at a young age (younger than 20)
• Low-income economic status, due to lower access to Pap tests, HPV tests, and precancer treatment
• A diet low in fruits and vegetables
• Family history of cervical cancer

Treating and Preventing Cervical Cancer

Cervical cancer treatment depends upon the stage of the cancer, says says Ritu Salani, MD, the director of Gynecologic Oncology at UCLA. Treatment options include:

• Local surgery for early-stage cervical cancer: This may include a cervical excision, which is a removal of the cervix and its surrounding tissue (also called a radical trachelectomy), or a conization, a removal of part of the cervix, Dr. Salani says. This early-stage procedure “spares the uterus for future childbearing, if fertility preservation is a concern,” Dr. Pothuri adds. Your doctor may also suggest a simple or radical hysterectomy, which removes the uterus as well as the cervix. For both the trachelectomy and hysterectomy, your doctor will also assess if your pelvic lymph nodes are affected and may need to be removed as well. If surgery isn’t an option, chemotherapy and radiation may also be used in Stage I cervical cancer.
• Radiation: This is the use of high energy x-rays or other particles to kill cancer cells. Your course of treatment will depend on your particular stage of cancer and unique health circumstances. Some experts will recommend radiation alone or surgery followed by radiation, while other stages of cervical cancer may require radiation combined with chemotherapy known as concurrent chemoradiation, according to the American Cancer Society. Radiation also tends to be used for cancers that have spread or are reoccurring.
• Chemotherapy: This involves the use of intravenous (via injection or infusion) or oral anticancer drugs used to kill cancer cells in the body. Chemo is given in cycles (often weekly or three weeks long) and involves rest periods for recovery, per the American Cancer Society.
• Immunotherapy: This type of therapy uses certain medications to increase the immune’s system ability to identify and kill cancer cells more effectively, per the American Cancer Society.

When it comes to preventing cervical cancer, the best thing you can do is get your HPV vaccine series, which reduces your risk of cervical cancer by nearly 90 percent, according to a 2020 study in the New England Journal of Medicine. This consists of either two shots in your preteen years (ideally ages 11 to 12) or three shots if you start the series later, at ages 15 through 26, according to the CDC. Doctors recommend getting the HPV vaccine at these younger ages, as you’re less likely to have been exposed to HPV already, but anyone under the age of 45 is eligible for the vaccine. But even if you’ve been vaccinated, Dr. Salani recommends practicing safe sex, such as using a condom, to lower your risk of HPV and cervical cancer.

In addition to getting vaccinated for HPV, you should also schedule regular Pap tests to screen for cervical cancer. The CDC recommends getting Pap tests starting at age 21. If your results are negative, you can get a Pap test every three years; if you’re also HPV-negative, you may be able to schedule it for every five years, so talk to your doctor about the best schedule for you. (If you have abnormal Pap test results, your doctor may recommend more frequent and/or additional screenings.)

Thanks to the HPV vaccine, Pap tests, and safe sex practices, it’s very possible to catch cervical cancer early on or even prevent it altogether. “The key thing is just to get screened,” Dr. Salani says. “Pap/HPV testing is only for cervical cancer, it does not detect uterine cancer or ovarian cancer, but it is really critical and should be part of routine healthcare.”

Related:

• What to Expect During a Pap Smear, According to Doctors
• This New Public Health Campaign Is Bringing Awareness to Racial Disparities in Cervical Cancer