No woman should die of cervical cancer, yet a plethora of women die. Cervical cancer develops in a woman’s cervix (the entrance to the womb from the vagina). It mainly affects sexually active women aged between 30 and 45. It is the lower part of the uterus, the place where a baby grows during pregnancy.
It is caused by human papillomavirus infection. Most human papillomavirus infection is harmless and clears spontaneously but persistent infection with high-risk human papillomavirus (especially type 16) can cause cancer of the cervix, vulva, vagina, anus, penis, and oropharynx. The virus exclusively infects epithelium and produces new viral particles only in fully mature epithelial cells. Human papillomavirus disrupts normal cell-cycle control, promoting uncontrolled cell division and the accumulation of genetic damage. Two effective prophylactic vaccines composed of human papillomavirus type 16 and 18, and human papillomavirus type 16, 18, 6, and 11 virus-like particles have been introduced in many developed countries as a primary prevention strategy. Human papillomavirus testing is clinically valuable for secondary prevention in triaging low-grade cytology and as a test of cure after treatment. More sensitive than cytology, primary screening by human papillomavirus testing could enable screening intervals to be extended. If these prevention strategies can be implemented in developing countries, many thousands of lives could be saved.
The virus spreads through sexual contact. Most women’s bodies are able to fight HPV infection. But sometimes the virus leads to cancer. One is at higher risk if one smokes, have had many children, use birth control pills for a long time, or have HIV infection.
Cervical cancer may not cause any symptoms at first. Later, one may have pelvic pain or bleeding from the vagina. It usually takes several years for normal cells in the cervix to turn into cancer cells. The health care provider can find abnormal cells by doing a Pap test to examine cells from the cervix. One may also have an HPV test. If results are abnormal, one may need a biopsy or other tests. By getting regular screenings, one can find and treat any problems before they turn into cancer.
The case is hundreds of millions of women are already beyond the age of vaccination, and without screening and preventive treatment, some 19 million will die from cervical cancer over the next 40 years. It is known from experience that the successful methods used to reduce incidence in high-income countries (Pap smear, colposcopy, biopsy) aren’t feasible at scale in low-resource settings. The basic tools for effective cervical cancer screening already exist and are getting better each year, but they are still out of reach for millions of women. Yet we believe that innovative approaches and emerging international commitment make it possible to ensure that all women have access to these lifesaving cancer-prevention tools. Treatment may include surgery, radiation therapy, chemotherapy, or a combination. The choice of treatment depends on the size of a tumour, whether cancer has spread and whether one would like to become pregnant someday. Vaccines can protect against several types of HPV, including some that can cause cancer