The cervix is the lower part of the uterus (womb) in the human female reproductive system. It is usually 2 to 3 cm long and roughly cylindrical in shape. The opening of the cervix is normally very narrow.

Cancer of the cervix (cervical cancer) is an abnormal and excessive growth of the cells at the cervix, which could potentially spread to other parts of the body. It occurs most commonly in women over 30 years.

Current Burden of Cervical Cancer in Nigeria
About 14,943 new cervical cancer cases are diagnosed annually in Nigeria, with about 8,030 deaths from the disease (estimates for 2018). So, it is quite common with high fatality rate.
Cervical cancer ranks as the 2nd leading cause of female cancer in Nigeria.
Cervical cancer is the most common female cancer in women aged 15 to 44 years in Nigeria.

Causes Cervical Cancer

Human Papilloma Virus infection: Almost all cases of cervical cancer are caused by the human papilloma virus (HPV).

Other factors that can increase the risk of having cervical cancer
• Having a weak immune system, e.g HIV patients
• Taking the oral contraceptive pill for more than 5 years.
• Starting sex at a very early age
• Having multiple sexual partners
• Having more than 5 children, or having them at an early age (under 17 years old)
• Your mother taking the hormonal drug diethylstilbestrol (DES) while pregnant with you.
• Smoking: women who smoke are twice as likely to develop cervical cancer than those who do not smoke; this may be because of the harmful effects of chemicals found in tobacco on the cells of the cervix

Facts about the Human Papilloma Virus (HPV)
HPV is spread during sexual intercourse and other types of sexual activity – such as skin-to-skin contact of the genital areas or using sex toys.
Actually, the HPV infection is very common. Most women will get some type of HPV infection at some point in their lives.
There are more than 100 different types of HPV.
Some types of HPV don’t cause any noticeable symptoms, while others can cause symptoms such as genital warts.
However, the two highest risk types are HPV 16 and HPV 18, which cause the majority of cervical cancer cases.

Symptoms of Cervical Cancer
The symptoms of cervical cancer are not always obvious, and it may not cause any at all until it has reached an advanced stage.
These may include:
1. Unusual bleeding
In most cases, abnormal vaginal bleeding is the first noticeable symptom of cervical cancer. This includes bleeding during or after sex, bleeding between your periods, and bleeding even after attaining menopause.
2. Pain and discomfort during sex
3. Unusual or unpleasant vaginal discharge
4. Lower back pain

In advanced cervical cancer;
If the cancer spreads out of the cervix and into surrounding tissue and organs, it can trigger a range of other symptoms, including:
o Pain in your lower back or pelvis
o Constipation
o Peeing or pooing more often than normal
o Losing control of your bladder or losing control of your bowels
o Blood in your pee
o Swelling of one or both legs
o Severe vaginal bleeding

What is Cervical Screening Test?
The Cervical Screening test (Pap Smear) is a screening method used to detect cervical cancer right on time. It is recommended that women start getting cervical screening between ages of 21 to 64 years. Women aged 21 to 49 should be screened every 3 years and those aged 50 to 64 should be screened every 5 years.

Having regular smears is important because cervical cancer rarely has symptoms before it spreads to other parts in the body.
Regular pap smears detect abnormalities that may lead to cancer of the cervix.
These abnormalities can be treated before cancer develops.

What happens during Cervical Screening test?
During cervical screening, a small sample of cells is taken from the cervix. These cells are subsequently viewed under a microscope for abnormalities.
An HPV test is usually done at the same time as a Pap test.

How can Cervical Cancer be diagnosed?
If you have had an abnormal cervical screening test result, or any symptoms of cervical cancer, you will usually be referred for a colposcopy.

What is Colposcopy?
This is an examination to look for abnormalities in your cervix. It involves using a small microscope with a light at the end (a colposcope) to look at your cervix. This microscope stays outside your body.
During this examination, a small tissue sample (biopsy) can be taken from the cervix so it can be checked for cancerous cells.

Further testing
If the results of the colposcopy or biopsy suggest you have cervical cancer and there’s a risk it may have spread, you will probably need to have some further tests to assess how widespread the cancer is.

Treatment for Cervical Cancer?
Treatment for cervical cancer depends on how far the cancer has spread.
For early cervical cancer – surgery to remove the cervix and some or all of the womb, or radiotherapy, or a combination of both
For advanced cervical cancer – radiotherapy with or without chemotherapy, and surgery is also sometimes used.
Can cervical cancer be cured?
Cervical cancer is often curable if it’s diagnosed at an early stage.
But cannot be cured in advanced stages. When cervical cancer is not curable, it is often possible to slow its progression, prolong lifespan and relieve any associated symptoms, such as pain and vaginal bleeding.

What can I do to prevent Cervical Cancer?
1. Get an HPV vaccine:
The vaccines require two or three doses. Vaccinating girls around the ages of nine to thirteen is typically recommended. The vaccines provide protection for at least 5 to 10 years.
The HPV vaccine is generally safe with no increased risk of serious adverse effects.
2. Get regular screening tests, including the Pap test and HPV test
3. Do not smoke
4. Limit sex partners
5. Sexual abstinence, or use of barrier protection (condom).

Special note for virgins
Do I need a cervical screening test if I’m a virgin?
If you’ve never had any sexual contact with a man or a woman or ever shared sex toys with someone else, then your risk of developing cervical cancer is very low.
Women who have never been sexually active may therefore decide not to have a cervical screening test.
However, you can still have a test if you want one.

IN SUMMARY
• Cervical cancer is a disease in which cancer cells form in the tissues of the cervix.
• Human papillomavirus (HPV) infection is the major risk factor for cervical cancer.
• There are usually no signs or symptoms of early cervical cancer but it can be detected early with regular check-ups.
. Early detection of abnormal cell growth at the cervix is very important for early intervention.
• Signs and symptoms of cervical cancer include vaginal bleeding and pelvic pain.
• Tests that examine the cervix are used to detect and diagnose cervical cancer.
• Certain factors affect chance of recovery and treatment options.

Dr. Pat [Alpha Women Forum]

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