Cervical cancer develops in the lining of the cervix, which is the lower part of the uterus (womb) entering the vagina (birth canal). Cells usually change from normal to pre-cancer and then to cancer over a number of years, although some cases can happen more quickly. These changes are referred to by several terms, including cervical dysplasia (also known as cervical intraepithelial neoplasia or CIN). For some women, these changes may go away without any treatment, but more often they need to be treated to prevent them from becoming true cancers.
Cervical cancer is one of the most common cancers affecting a woman's reproductive organs. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, are responsible for most cases of cervical cancer.
Low-grade CIN or dysplasia indicates a minimal change in cells, and high-grade CIN indicates a greater degree of abnormality. CIN may progress to squamous intraepithelial lesion (SIL), a condition preceding cervical cancer, or to carcinoma in situ, a cancer not extending beyond the epithelial membrane. SIL is also classified as low or high-grade, and high-grade SIL or carcinoma in situ may progress to invasive carcinoma (cancer that has spread to healthy tissue).
There are two main types of cervical cancer. Squamous cell carcinomas occurs about 80-90% of the time, and the other 10 to 20% develop in the glands called adenocarcinomas. If the cancer has features of both types it is known as mixed carcinoma. Human papilloma virus (HPV), a virus that causes genital warts, is the primary cause in more than 90% of cervical squamous cell carcinomas.
The American Cancer Society predicts that there will be about 11,150 new cases of invasive cervical cancer in the United States in 2007. About 3,670 women will die from this disease that same year, and it most commonly develops in women aged 40 years or older. Currently, 11% of U.S. women report that they do not have regular cervical cancer screenings.
Cancer of the cervix is the second most common cancer in women worldwide, and is a leading cause of cancer-related death in women in underdeveloped countries.
Since 1955 the number of deaths from cervical cancer has declined considerably, mainly due to the use of a diagnostic test called the Pap test/ Pap smear. This test has the ability to find cervical cancer early.
Invasive cervical cancer is more common in middle aged to older women, and in women of poor socioeconomic status who are less likely to receive regular screening and early treatment. The incidence rate is higher among African American, Hispanic, and Native American women.
With early detection, especially Pap smears, nearly every case of cervical cancer can be prevented or cured.
Treatment consists of surgery (including local excision) in early stages and chemotherapy and radiotherapy in advanced stages of the disease. An effective vaccine, the HPV vaccine, for the two most common strains of HPV has recently been licensed.
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