Cervical Cancer

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Overview, Causes, & Risk Factors

The development of cervical cancer is gradual and begins as a pre-cancerous condition called dysplasia. In this form it is 100% treatable, usually without the need for a hysterectomy (surgical removal of the uterus).

Dysplasia, depending on its severity, can resolve without treatment, particularly in young women. However, it often progresses to actual cancer called "carcinoma in situ" (CIS) if it has not spread, or "microinvasive" if it has spread only a few millimeters into the surrounding tissue and not into the lymph channels or blood vessels.

It may take years for dysplasia to turn into carcinoma in situ or microinvasive cancer, but once this process occurs the cancer can quickly spread deeper into nearby tissues or other organs, such as the bladder, intestines, liver, or lungs.

Usually patients with cervical cancer do not experience problems until the cancer is advanced and has spread. A Pap smear can pick up dysplasia and early forms of cervical cancer that have not yet spread. Most women diagnosed today with cervical cancer have either not had regular Pap smears or they have not followed up after having an abnormal smear.

The risk factors for cervical cancer are:

• Infection with the virus that causes genital warts (human papilloma virus or HPV) may increase the risk of developing dysplasia and subsequent cancer. Fortunately, not all women who have had HPV infection or genital warts develop cervical cancer. Some scientists believe that other factors, such as smoking, may increase the risk of developing cervical cancer in those who have had HPV.
• Early age at first sexual intercourse.
• Multiple sexual partners and/or partners who have multiple partners.
• In the early 1970's, it was discovered that women whose mothers took an estrogen drug during pregnancy called DES (diethylstilbestrol) are at risk of a rare form of cervical and vaginal cancer. For more information go to the DES Action web page.
• There is a small increased risk of abnormal Pap smears among women who take birth control pills. It is thought that this is because such women are more sexually active, are less likely to use condoms, and have more frequent Pap smears in order to be prescribed the birth control pill.
• Women whose immune systems are weakened -- such as those with HIV infection or women who have received organ transplants and are taking drugs to suppress the immune system -- may be at a higher risk.
• Infections with genital herpes or chronic chlamydia infections, both sexually transmitted diseases, may increase risk.
• Poor women may be at higher risk because they are uninsured or not able to afford regular pap smears.

Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the U.S. because most women have routine Pap smears that can detect the early treatable forms of the disease.

It is thought that the Pap smear has reduced the death rate from this disease by 70% since it was introduced in 1941. However, many women are still diagnosed with cervical cancer in the U.S. In the year 2000, 12,800 women were diagnosed with cervical cancer and there were 4,600 deaths from this disease.