Cervical cancer awareness and symptoms

Each year, over 2,900 women are diagnosed with cervical cancer in the UK. It usually occurs in women over the age of 20. The highest rates occur between the ages of 30-39, but it can also affect younger and older women.

Cancer of the cervix can take many years to develop. Before it does, changes occur in the cells of the cervix. These changes are known as cervical intraepithelial neoplasia (CIN).

The abnormal cells are not cancerous, but some doctors refer to the changes to these cells as “pre-cancerous”. Pre-cancerous changes of the outer (squamous) cells of the cervix are those that have the potential to turn into cancer if left untreated for some time.

There are different grades of CIN according to how severe the changes are, from CIN1 (minor change) to CIN3 (the most severe change). The risk of developing cancer is related to the grade of CIN. We know that most cases of CIN1 will go back to normal without any treatment. The risk of CIN1 developing into cancer is very small. However we know that CIN2 and CIN3 may develop into cancer in some cases, if left untreated.

Human papillomavirus (HPV) infection appears to be involved in the development of more than 90% of cases, most people who have had HPV infections, however, do not develop cervical cancer. HPV is a very common virus that can cause changes to the cells of the cervix creating abnormalities. Once these abnormalities become severe they can develop into cancer which is why cervical screening is important in helping to prevent cervical cancer.

Around 20% high-risk types of HPV are responsible for over 90% of all cervical cancers. Within the high-risk group types 16 and 18 are the most prevalent, causing over 70% of cervical cancers.

Having a weakened immune system may allow CIN to develop into cancer. The immune system can be weakened by smoking, a poor diet and infections such as HIV/AIDS. Women who smoke are more likely to develop CIN and the most common type of cervical cancer, known as squamous cell cervical cancer. Cervical cancer typically develops from precancerous changes over 10-20 years.

There is no inherited predisposition to cervical abnormalities, CIN or cervical cancer.

The most common symptoms of cervical cancer are:                                                                              

  • Abnormal vaginal bleeding, usually between periods or after sex.
  • Women who have gone through the menopause (who are no longer having periods) may find they have some new bleeding.
  • Smelly vaginal discharge and discomfort during sex.

Very early-stage cervical cancer may have no symptoms. This means it’s important to attend regular cervical screening, so that any cells can be picked up early.

If you are attending regular screening, you should let your GP know if you develop symptoms between your tests.

There are many other conditions that can cause these symptoms, but it’s important that you see your GP or practice nurse to get them checked out.

Regular cervical screening is important to detect abnormalities that can be treated to prevent cancer developing. Each year screening saves around 5,000 lives in the UK. Not going for the cervical screening is one of the biggest risk factors for developing cervical cancer.

 This article was written by Miss Farida Bano FRCOG, consultant gynaecologist at Spire Roding Hospital.

View Miss Bano’s full consultant profile.

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