Cervical cancer

Cervical cancer incidence and death rates have dropped steadily over the past few decades, in large part owing to regular Pap test screening. According tothe Canadian Cancer Society, incidence rates have declined two per cent per year from 1995 to 2004.

Still, nearly 1,400 Canadian women were diagnosed with cervical cancer in 2006, according to health officials. They say this cancer can be prevented and, in most cases, can be cured if treated early.

What is cervical cancer?

This type of cancer begins in the cervix, the lower part of the uterus or womb, which opens into the vagina.

Early changes in the cells of the cervix can happen without pain or other symptoms. If not found and treated, cell changes in the cervix can grow into cancer, which can spread to other parts of the body.

There are two main types of cervical cancer. The most common type, squamous cell cancer, starts in the cells that line the surface of the cervix. Adenocarcinoma, which is less common, starts in the mucous-secreting glandular tissue of the cervix. The cervix has these gland cells along the inside of the passageway that runs from the cervix to the womb.

What causes cervical cancer?

A virus called human papilloma virus (HPV) is responsible for most cases of cervical cancer. HPV is spread through sexual contact. The virus is said to infect half of all sexually active women between ages 18 and 22 in North America. In most women, the virus clears up on its own, but if the infection persists, it can lead to cervical cancer.

On July 2006, Health Canada approved a vaccine that protects against the human papilloma virus. Gardasil has been approved for females between nine and 26 years of age.

"Until now, we have only been able to react to the effects of HPV in women," said Dr. Guylaine Lefebvre, the president-elect of the Society of Obstetricians and Gynecologists of Canada.

"Now we are talking about preventing most of the serious diseases caused by HPV." Since the vaccine doesn't prevent infection from all strains of HPV, women would still need to get a Pap test to screen for the virus.

Other factors that appear to increase the risk of cervical cancer include:

• Multiple sex partners or a partner who has had a number of sexual partners.
• Sexual activity at a young age.
• Smoking.
• Suppression of the immune system by drugs after an organ transplant or condition such as AIDS.

What are the symptoms?

In general, early cervical cancer produces no signs or symptoms. As the cancer advances, the following symptoms may appear:

• Abnormal bleeding after intercourse, between periods or after menopause.
• Increased vaginal discharge.
• Health officials say these symptoms may be caused by cancer or by other health problems. Contact your doctor if you have any of these symptoms.

How is cervical cancer detected?

The Pap test is used to detect cervical cancer before it has fully developed and when treatment can be effective.

During the test, the doctor brushes cells from the cervix, smears them onto a glass slide, and then sends the sample to a lab.

According to Health Canada, the death rate from cervical cancer has dropped almost 50 per cent since the introduction of the Pap test.

What treatments are available?

Treatment depends on the stage of the cancer. It may include the following:

• Surgery, which involves removing cancerous cells.
• Radiation therapy, which uses high-energy x-rays or other types of radiation to kill or shrink the cancer cells.
• Chemotherapy, which utilizes drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing.