The cervix is the lower part of the uterus, and is often called the neck of the womb. Cancer can develop slowly over many years, and is preceded by changes in the cells of the cervix, known as cervical intraepithelial neoplasia (CIN). These abnormal cells are not cancerous, and most women with CIN do not develop cancer, but it is a risk if not treated. These changes can then be treated successfully before cancer develops (1).
The most common symptom of cervical cancer is abnormal vaginal bleeding, usually between periods or after sex. Post-menopausal women (who are no longer having periods) may find they have new bleeding. Symptoms can also include a smelly vaginal discharge and discomfort during sex.
The very early stages of cervical cancer may have no symptoms. This means it’s important to attend regular cervical screenings, so that any abnormal cells can be picked up early. If you are attending regular screening, you should let your doctor 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 doctor to get them checked out.
Risk factors for cervical cancer
CIN and cervical cancer is caused by a viral infection with human papillomavirus (HPV). HPV is a very common virus which is most commonly passed on through sexual intercourse (1). HPV only causes cervical smear abnormalities if it is not cleared from the body over a period of years (1).
You should be aware that smoking can make clearing HPV from the body less effective and can make clearance of minor smear abnormalities slower and less efficient. For this reason stopping smoking may be advised by your doctor or staff in the colposcopy clinic (1).
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 (1).
There is no inherited predisposition to cervical abnormalities, CIN or cervical cancer.
Regular cervical screening is important to detect abnormalities which can be treated early to prevent cancer developing. Not going for cervical screening is one of the biggest risk factors for developing cervical cancer.
In the UK, the NHS provides free cervical screening tests for all women within a specific age range who are registered with a GP. In England, Northern Ireland and Wales, the NHS cervical screening programme invites women from ages 25 to 64 for cervical screening. Women aged 25 to 49 are invited every 3 years. After that, women are invited every 5 years until the age of 64 (1).
If abnormal cells are found during your cervical screening test, you will be referred for a colposcopy to have a biopsy taken. Colposcopy is a simple outpatient clinic procedure to examine the cervix. As an experience it is very similar to having a smear test performed.
Spire Roding Hospital provides the full range of smear/colposcopy clinics. Our website provides the latest information and advice on colposcopy and gynaecological problems such as abnormal smears, HPV and CIN.
Dr Farida Bano MBBS, FRCOG, Consultant Gynaecologist
1) Colposcopy and Programme management BNHSCSP Publication 20