Cervical Cancer
WHAT IS CERVICAL CANCER?
The cervix is the lower part of the uterus that connects the uterus to the vagina. It produces mucus to protect the upper reproductive organs from bacteria and prevents the entry of sperm into the uterus during most of the menstrual cycle. The cervix also dilates, or widens, to facilitate childbirth. Cells in the cervix may become pre-cancerous or develop into cancer. These cells can spread, or metastasize, to other parts of the body such as the uterus, bladder, lungs, or bone. In 2021, it was estimated that 1450 Canadians would be diagnosed with cervical cancer with 380 deaths.
What are the symptoms of cervical cancer?
Cervical cancer may not have any symptoms until it spreads to other tissues and organs. Thus, it is very important to be screened for cervical cancer via a Pap test. Some symptoms of cervical cancer include abnormal vaginal bleeding or discharge, pain during intercourse, difficulty urinating or having a bowel movement, loss of appetite, weight loss, shortness of breath, and fatigue. The main risk factor for cervical cancer is infection with the human papillomavirus (HPV).
WHAT IS HPV?
HPV is one of the most common sexually transmitted infections (STIs) in Canada. HPV can be transmitted during vaginal, oral, or anal sex, or intimate skin-to-skin contact. It is estimated that up to 75% of sexually active people will be infected with anogenital HPV in their lifetime. While most people will clear the infection naturally, a small amount of people will develop cancer.
HPV infection may not have any symptoms. A common symptom is anogenital warts, which may look like a small cauliflower or be flat. These warts may be inside the body or be too small to be seen. HPV causes almost all cervical cancers, but is also related to cancer of the throat, oral cavity, penis, anus, vagina, or vulva. In Canada, Gardasil®, Gardasil®9 (for females and males) and Cervarix® (for females only) are vaccines that are both safe and effective in preventing HPV infection and associated changes in the cervix.
HOW IS CERVICAL CANCER DETECTED?
The Pap test is performed to look for changes in the cells of the cervix and detect cervical cancer. During this in-office test, a doctor will collect a small sample of cells from the surface of your cervix. The sample will be sent to a lab for examination under a microscope.
When do I need a pap test?
The guidelines for when to have a Pap test vary from province to province. In Alberta in 2022, it is recommended that people with female reproductive organs aged 25 to 69 have a Pap test every three years. Those under 25 years old do not require routine screenings. If you are 70 or older and have had three negative Pap tests in a row in the last 10 years, screening is no longer needed.
What if my pap test results are abnormal?
An abnormal Pap test result does not always indicate cervical cancer. It may mean that you have changes on your cervix that could go away on their own. In some cases, these changes could lead to cervical cancer. Abnormal results may also be due to infection of the vagina or cervix, low estrogen levels after menopause, or an IUD. If your test is abnormal, you may need another Pap test within a few weeks or months. If pre-cancer is suspected, your doctor may recommend a colposcopy, a procedure where the cervix is examined with a magnifying instrument called a colposcope. During this procedure, the doctor may take a biopsy from the cervix that will be sent to the lab for analysis.
Further Reading:
Canadian Cancer Society, Cervical Cancer
Government of Canada, Human papillomavirus (HPV)
