Cervical Cancer Quiz

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the U.S. and it is found in about 99% of cervical cancers. Of the more than 100 different types of HPV, two types of the virus - HPV-16 and HPV-18 - are the main causes of cervical cancer.

It is important to note that most women infected with HPV do not develop cervical cancer and most HPV infections will eventually go away on their own.

Aside from human papillomavirus (HPV) infection, the main risk factor for cervical cancer, other risk factors include:

• Smoking
• Weakened immune system (HIV/AIDS, taking immunosuppressive medications)
• Family history of cervical cancer
• Multiple sexual partners
• Being overweight/obese
• A diet low in fruits and vegetables
• Long-term use of oral contraceptives (birth control pills)
• Intrauterine device (IUD) use
• Multiple full-term pregnancies
• Age younger than 17 at first full-term pregnancy
• Economic status (low income women have less access to Pap tests for cervical cancer screening)
• Chlamydia infection
• Having a mother who took diethylstilbestrol (DES) during pregnancy (between 1940-1971)

In the early stages, cervical cancer usually does not cause symptoms. This is why Pap and HPV testing is important to detect possible cancerous cells early.

Once cervical cancer is more advanced, symptoms may include:

• Abnormal or irregular vaginal bleeding (bleeding between periods, after a pelvic exam, after sexual intercourse, after douching, or after menopause)
• Painful sexual intercourse
• Heavy or unusual vaginal discharge (may be watery, thick, or have a foul odor)
• Pelvic pain not related to your menstrual cycle
• Increased urinary frequency
• Painful urination

It takes many years for cervical cancer to develop and spread. In the early stages cell changes that occur before cancer is detected are called dysplasia or cervical intraepithelial neoplasia (CIN).

Many women are diagnosed with precancerous cell changes (dysplasia) in their 20s and 30s but the average age of diagnosis of cervical cancer is age 49, which indicates the slow progression of the disease.

• Smoking
• Previous abnormal Pap test, abnormal HPV test, or treatment for precancerous cervical lesions
• Anew sexual partner since the last Pap test
• A mother took diethylstilbestrol (DES) while pregnant

• The hysterectomy did not remove the cervix
• The hysterectomy was done because of cervical cancer or pre-cancer
• Your mother took diethylstilbestrol (DES) while pregnant

A number of tests may be used to diagnose cervical cancer.

• Pap test (Pap smear): Cells are scraped off the cervix to be tested for cancer and pre-cancer.
• Colposcopy: A lighted magnifying device looks inside the vagina and cervix.
• Cervical biopsy: A small piece of tissue is taken. This is the only definitive way to be sure if you have cancer.

• CT (computed tomography) scan: Detailed images of the body can see if cancer has spread.
• Chest x-rays: May be done to see if the cancer has spread to your lungs.
• PET (positron emission tomography) scans: A radioactive substance is ingested, injected, or inhaled. The scan detects where the radioactive substance has built up, which may indicate cancer.

Treatment for cervical cancer depends on the stage of the cancer and surgery is the main treatment.

Types of surgery to treat cervical cancer include:

• Cryosurgery: kills cancer cells by freeing them. Only used for stage 0 cancers.
• Laser surgery: uses a laser to burn cancer cells. Only used for stage 0 cancers.
• Conization: removal of all or part of the cervix that has the cancer while leaving the uterus intact.
• Radical hysterectomy: removal of the cervix, uterus, and upper part of the vagina.

• Radiation therapy: External beam radiation aims radiation at the cervix from a machine outside the body. Brachytherapy inserts a radioactive source inside the vagina.
• Chemotherapy: Drugs are used to help kill or slow the progression of the cancer.
• Targeted therapy: Newer drugs are used to specifically target the cancer cells.
• Immunotherapy: Stimulates the immune system to help the body fight the cancer.

The life expectancy for women with cervical cancer depends on the stage of the cancer. Survival rates are typically higher for women in the earlier stages. Other factors that can impact the prognosis include the woman's age, overall health, and her response to treatment. Survival is often expressed as a "5-year survival rate" which is the percentage of people who live at least 5 years after being diagnosed.

• Stage 0 and Stage IA: The 5-year survival rate is 93%. This means 93% of those diagnosed at this stage will be alive in 5 years.
• Stage IB: 80%
• Stage IIA: 63%; Stage IIB: 58%
• Stage IIIA: 35%; Stage IIIB: 32%
• Stage IVA: 16%; Stage IVB: 15%

The earlier the stage of the cervical cancer, the more options there are for a possible cure.

• All cases of Stage 0 cervical cancer (called carcinoma in situ, or CIS) can be cured if treated properly.
• A hysterectomy (surgical removal of the cervix and uterus) can cure cervical cancer if it has not spread to other parts of the body.

Since most cases of cervical cancer are caused by human papillomavirus (HPV) infection, the HPV vaccine is recommended to protect against the types of HPV that can cause cervical cancer.

The HPV vaccine is recommended for both girls and boys aged 11 to 12 years, but it can be administered as early as age 9, and up until a person is 26 years old. Even women who have been vaccinated against HPV should still have regular Pap tests to screen for cervical cancer.

Other lifestyle changes that may help reduce the risk of developing cervical cancer include:

• Not smoking
• Having only a few sexual partners
• Using condoms during sex (HPV infection may still occur with condom use, but condom use is associated with a lower risk of cervical cancer).