Cervical cancer is one of the most preventable cancers. It is a cancer found in the cells of the cervix which is the lower part of the uterus or womb.
Persistent HPV infection, usually with certain high-risk types of HPV, can cause abnormal cells to develop on the cervix.
There are two main types of cervical cancer:
Squamous cell carcinoma is the most common type of cervical cancer, accounting for about 80 per cent of all cases. It starts in the squamous cells that line the outer surface of the cervix.
Cervical cancer risk factors
- Adenocarcinoma accounts for about 20 per cent of cervical cancers. It develops from the glandular cells, often located higher up in the cervix.
- Cervical cancer is now an uncommon disease in Australia. The number of women diagnosed with cervical cancer has halved since the introduction of the National Cervical Screening Program in 1991.
It is estimated that in 2017, 912 women were diagnosed with cervical cancer and 254 women will die from the disease.
Cervical cancer symptoms
- Human papillomavirus (HPV) infection is found in almost all cases of cervical cancer.
Increasing age, smoking and lowered immunity may increase the risk of cervical cancer.
In the early stages of cervical cancer, there are usually no symptoms at all. Should symptoms appear they may include:
What is HPV
HPV and cancer
- abnormal vaginal bleeding (between periods, after menopause or after sex)
- unusual vaginal discharge
- pain during intercourse
- excessive tiredness
- leg pain or swelling
- lower back pain.
There are different HPV types – some are considered ‘low-risk’ and others ‘high-risk’. Low-risk HPV types cause genital warts and do not cause cancer. Some high-risk HPV types can cause serious illness including cancer.
In most cases the immune system clears HPV from the body. However, there are times when the body does not clear HPV– usually when the infection is with high-risk types. We call this 'persistent' HPV infection.
Testing for HPV to prevent cervical cancer
The new Cervical Screening Test detects human papillomavirus (HPV) infection, which is the first step in developing cervical cancer.
The procedure for collecting the sample for HPV testing is the same as the procedure for having a Pap smear. A healthcare provider will still take a small sample of cells from the woman’s cervix. The sample will be sent to a pathology laboratory for examination.
While the Pap test could detect abnormal cell changes, the new Cervical Screening Test detects the HPV infection that can cause the abnormal cell changes, prior to the development of cancer.
Persistent HPV infections can cause abnormal cell changes that may lead to cervical cancer. However, this usually takes a long time, often more than 10 years.
On 1 December 2017, the Pap test was replaced with the Cervical Screening Test. The new program is expected to reduce cervical cancer incidence and mortality by up to 30%.
The Renewed National Cervical Screening Program
On 1 December 2017 the two yearly Pap test for women aged 18 to 69 changed to a five yearly human papillomavirus (HPV) test for women aged 25 to 74. The Cervical Screening Test, which tests for HPV, is more effective at preventing cervical cancer. Women are due for the first Cervical Screening Test two years after their last Pap test. The changes include:
- women are invited when they are due to participate via the National Cancer Screening Register
- the Pap smear has been replaced with the more accurate Cervical Screening Test
- the time between tests changed from two to five years as the Cervical Screening Test detects HPV, which means testing isn’t required as frequently
- the age at which screening starts increased from 18 years to 25 years
- women aged 70 to 74 years are invited to have an exit test.
Women of any age who have symptoms such as unusual bleeding, discharge and pain should see their health care professional immediately.
HPV vaccinated women still require cervical screening as the HPV vaccine does not protect against all the types of HPV that cause cervical cancer.
The Gardasil vaccine protects against the two high-risk HPV types (types 16 and 18), which cause 70% of cervical cancers in women and 90% of all HPV-related cancers in men. It also protects against two low-risk types (types 6 and 11), which cause 90% of genital warts.
All boys and girls aged 12-13 should have the HPV vaccine. The vaccine is most effective if given before exposure to HPV, which means before sexual activity commences.
Gardasil is available free of charge through the school-based National HPV Vaccination Program and involves three injections in the upper arm. The vaccine works best over a six-month period, with the second dose of the vaccine two months after the first, and the third dose four months after the second (at 0, 2 and 6 months).
The link between cervical Cancer and HPV
Information to come.