Cervical cancer
Location of cervical cancer and an example of normal and abnormal cells
Pronunciation	UK: /sɜːˈvaɪ.kl/, US: /ˈsərvɪkl/ [1]
Specialty	Oncology
Symptoms	Early: none [2] Later: vaginal bleeding, pelvic pain, pain during sexual intercourse [2]
Usual onset	Over 10 to 20 years [3]
Types	Squamous cell carcinoma, adenocarcinoma, others [4]
Causes	Human papillomavirus infection (HPV) [5] [6]
Risk factors	Smoking, weak immune system, birth control pills, starting sex at a young age, many sexual partners or a partner with many sexual partners [7] [4] [8]
Diagnostic method	Cervical screening followed by a biopsy [7]
Prevention	Regular cervical screening, HPV vaccines, condoms [9] [10]
Treatment	Surgery, chemotherapy, radiation therapy, immunotherapy [7]
Prognosis	Five-year survival rate: 68% (US) 46% ( India) [11]
Frequency	570,000 new cases (2018) [12]
Deaths	311,000 (2018) [12]

Cervical cancer is a cancer arising from the cervix. ^[2] It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. ^[13] Early on, typically no symptoms are seen. ^[2] Later, symptoms may include abnormal vaginal bleeding, pelvic pain, pain during sexual intercourse, and sometimes problems with bowel and bladder function. ^[2] While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer. ^[14]

Human papillomavirus infection (HPV) causes more than 90% of cases. ^{[5] [6]} Most people who have had HPV infections, however, do not develop cervical cancer. ^{[3] [15]} Other risk factors include smoking, a weak immune system, birth control pills, starting sex at a young age, and having many sexual partners, but these are less important. ^{[4] [7]} Cervical cancer typically develops from precancerous changes over 10 to 20 years. ^[3] About 90% of cervical cancer cases are squamous cell carcinomas, 10% are adenocarcinoma, and a small number are other types. ^[4] Diagnosis is typically by cervical screening followed by a biopsy. ^[7] Medical imaging is then done to determine whether or not the cancer has spread. ^[7]

HPV vaccines protect against two to seven high-risk strains of this family of viruses and may prevent up to 90% of cervical cancers. ^{[10] [16] [17]} As a risk of cancer still exists, guidelines recommend continuing regular Pap tests. ^[10] Other methods of prevention include having few or no sexual partners and the use of condoms. ^[9] Cervical cancer screening using the Pap test or acetic acid can identify precancerous changes, which when treated, can prevent the development of cancer. ^[18] Treatment may consist of some combination of surgery, chemotherapy, and radiation therapy. ^[7] Five-year survival rates in the United States are 68%. ^[19] Outcomes, however, depend very much on how early the cancer is detected. ^[4]

Worldwide, cervical cancer is both the fourth-most common cause of cancer and the fourth-most common cause of death from cancer in women. ^[3] In 2012, an estimated 528,000 cases of cervical cancer occurred, with 266,000 deaths. ^[3] This is about 8% of the total cases and total deaths from cancer. ^[20] About 70% of cervical cancers and 90% of deaths occur in developing countries. ^{[3] [21]} In low-income countries, it is one of the most common causes of cancer death. ^[18] In developed countries, the widespread use of cervical screening programs has dramatically reduced rates of cervical cancer. ^[22] In medical research, the most famous immortalized cell line, known as HeLa, was developed from cervical cancer cells of a woman named Henrietta Lacks. ^[23]

References