Cervical cancer is one of the most preventable cancers. A cervical screening test every five years can help save lives. If the COVID-19 pandemic has stopped you from being screened, please see your doctor as soon as possible for your CST.

Cervical cancer - A Preventable cancer

Cervix is the lower part of the uterus, and cervical cancer is the growth of abnormal cells in the lining of the cervix. There are two types of cervical cancer: squamous cell carcinoma (~ 70% of cases) and adenocarcinoma (~ 25% of cases).

Incidence of Cervical Cancer

The incidence of cervical cancer has significantly decreased since the National Cervical Screening Program began in 1991, and a national Human Papilloma Virus (HPV) vaccine program was introduced in 2007. 

In 2009, it ranked the twelfth most common cancer in Australian women while in 1982 cervical cancer was the sixth most common cancer in Australian women.

Signs & Symptoms of Cervical cancer

• Unusual or persistent vaginal bleeding (between periods, post-coital or post-menopausal bleeding)
• Deep pain during intercourse
• Persistent or unusual vaginal discharge (offensive and/or blood stained)          

Causes of cervical cancer

HPV infections can cause the development of benign or malignant lesions.

• Benign lesions (caused by HPV 6 and 11) are non-genital and anogenital skin warts, oral and laryngeal papillomas and anogenital mucosal condylomata.
• Persistent infection with oncogenic HPV (high-risk type) can result in the development of cancers of the cervix, anus, penis, vulva and vagina.
• HPV infections are transmitted mainly by skin-to-skin or mucosa-to-mucosa contact. Therefore, genital skin-to-skin contact, vaginal sex, oral sex, and anal sex may facilitate the transmission of HPV.

Other risk factors include:

• smoking
• a weakened immune system
• If your mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone oestrogen during pregnancy (between 1939 and 1971).

Diagnosis of cervical cancer

• Cervical screening Test
• Colposcopy with biopsy -  A colposcopy is a procedure used to look closely at the cervix, vagina and vulva to help locate abnormal cells and take biopsy as needed. Click here for details on colposcopy. 
• LLETZ - A large loop excision of the transformation zone (LLETZ) is a common procedure to remove cervical tissue for examination and treatment of pre-cancerous changes of the cervix. 

Treatment for cervical cancer

Staging

If cervical cancer is detected, further treatment will be based on the extent of spread of the disease where Stage 1 would mean a localised disease and Stage 4 would mean that the cancer has spread beyond the pelvis (lung, liver or bones).

Types of treatment

Treatment depends on the disease stage.

• For localised disease treatment is surgery (Cone biopsy or Hysterectomy )+ / - Chemoradiation 
• For locally advanced disease, a combination of radiation therapy and Chemotherapy
• For metastatic disease, the treatment is chemotherapy or palliative care.

Screening for cervical cancer

The Cervical screening test (started in December 2017) is the renewed program. It is expected to further reduce the risk of cervical cancer and deaths by at least another 20%. It has replaced the Pap test. This test now looks for HPV (which causes almost all cervical cancers).

• You are eligible for cervical screening if you are 25 to 74 years old, have a cervix and have ever been sexually active.
• Vaccinated and unvaccinated women are recommended to be tested
• Pregnant women who are due for a Cervical Screening Test should still be screened. It is safe to be screened in pregnancy, and Cervical Screening Tests have not been linked to increased rates of miscarriage.

Preventing cervical cancer

HPV vaccine

Through the National Immunisation Program, most girls and boys in Australia aged 12-13 and under receive the HPV vaccine in school-based programs. It is given as two injections. This is a vaccine against specific types of HPV that cause almost all cervical cancers. Gardasil 9 has been developed to protect against nine types of HPV which cause around 90% of cervical cancers. The vaccine is most effective if the second dose is given 6-12 months after the first.