Currently, cancer is the cause of nearly 12 percent of deaths across the globe. The number is anticipated to increase to over 12 million people in 2030 (American Cancer Society, 2016). One of the diseases that have claimed the lives of very many women is cervical cancer. Cervical cancer is second in terms of incidence and mortality rate. The worldwide estimate for 2016 is 528000 incidences and 266000 deaths. However, the incidence rate has reduced by half in the last three decades owing to the extensive endorsement of the Papanicolaou test and the removal of precancerous cells (American Cancer Society, 2016).
Nearly 90 percent of cervical cancer deaths occur in the least developed countries. Nonetheless, both prevalence and mortality rates exhibit considerable differences across the world (Reis, Beji, & Kilic, 2011). Studies show that cervical cancer incidence rate and mortality rate increase with age. In other words, aging women have a great risk of developing cervical cancer (American Cancer Society, 2016). This paper is aimed at exploring the nature and causes of cervical cancer. The paper also examines its diagnosis, as well as prevention and treatment.
Nature and Cause of Cervical Cancer
Cancer starts when cells in a section of the human body begin to grow uncontrollably and abnormally. The difference between cancer cells and normal cells is that cancer cells do not fade away. Also, these cells invade other tissues, something that never happens with normal cells (American Cancer Society, 2016). All cancers are named after their place of origin. Cervical cancer originates from the cells lining the cervix. To be specific, in the transformation zone. The transformation zone is where the cells lining the ectocervix (squamous cells) and endocervix (glandular cells) converge (American Cancer Society, 2016).
These cells do not all of a sudden become cancerous. Rather, the ordinary cells of the cervix slowly create precancerous changes that transform into cancer. The classification of cervical cancers and cervical pre-cancers is based on how they appear under the microscope. The main categories of the disease include squamous cell carcinoma and adenocarcinoma. The majority of cervical cancers (85% to 90%) are squamous cell carcinoma (American Cancer Society, 2016). The incidence rates of cervical cancer are pegged on certain risk factors. High cases of cervical cancer are attributed to human papillomavirus (HPV) infection, particularly types 16 and 18. Other risk factors include smoking, aging, birth control pills, multiple pregnancies, and immune system deficiency (Arbyn et al., 2011).
The human papillomavirus (HPV) are classified into high-risk categories and low-risk categories. The high-risk types include 16 and 18, while the low-risk types include 6, 44, 81, and CP6108 (Cancer.Net, 2016). Smoking is considerably associated with different types of communicable diseases, including cancer. Even though tobacco smoking is commonly linked to lung tumors, it is also very harmful to the cervix. Studies show that smoking increases cervical cancer incidence by 30 percent (Arbyn et al., 2011).
Birth control pills are also linked to the increased risk of cervical cancer. Long-term use of oral contraceptives enhances the risk of cervical cancer by 30% to 40% (Cancer.Net, 2016). Similarly, multiple pregnancies increase the risk by more than 30 percent. This is because pregnancy is associated with unprotected intercourse, which increases exposure to human papillomavirus and other sexually transmitted diseases (STIs). Last but not least, a feeble immune system makes women more susceptible to human papillomavirus and other forms of ailments (Arbyn et al., 2011).
Signs and Symptoms of Cervical Cancer
During the initial stages, cervical cancers do not exhibit any symptoms. The symptoms only start to show after the pre-cancer turns out to be invasive and attacks neighboring tissues. The most common symptom is vaginal bleeding, especially after sexual intercourse or pelvic examination. The vaginal mass is also a symptom of malignancy (American Cancer Society, 2016). In the advanced stages, the following symptoms may be exhibited: excessive loss of weight, exhaustion, pain in the pelvic region, swollen legs, leg pain, extreme vaginal bleeding, pain during sex, loss of desire for food, heavy menstrual bleeding, and urine or fecal leakages from the vagina (American Cancer Society, 2016).
Prevention and Treatment
Because many types of cervical cancer begin with pre-cancerous changes, they can be averted in two ways, namely: preventing pre-cancer from developing into full cancer and surgical removal of cancerous cells (Carson & Hladik, 2009). A well-proven approach to averting cervical cancer is screening for pre-cancers before they transform into intrusive malignancy. The test includes a Pap test (at times referred to as Pap smear). A Pap test entails taking a sample of cells from the exocervix, endocervix, and the vaginal cuff for the laboratory screening (Carson & Hladik, 2009).
The collected cell samples can be prepared for the laboratory screening by either using conventional cytology or liquid-based cytology. The conventional cytology involves smearing the sample directly into the microscope slide, spraying it with stabilizers, and sending it for the lab test. On the other hand, liquid-based cytology involves immersing the sample into a special fluid before sending it for the lab test (American Cancer Society, 2016).
Cytological tests lead to the detection of abnormal cells. Cytological tests involve the use of Papanicolaou stain, which is a multi-chromatic staining approach that was invented by George Papanikolaou. Papanicolaou staining is very useful and effective in differentiating cells from a smear sample (Carson & Hladik, 2009).
The most broadly utilized framework for describing Papanicolaou test results is the Bethesda framework, which has three principal classifications:
- Negative for intraepithelial lesion or malignancy (no indication of cancer, pre-cancer conditions or other significant cell abnormalities),
- Epithelial cell abnormalities (presence of cancer or pre-cancer changes),
- Other malignant neoplasms (other forms of malignancy that seldom affects the cervix).
The treatment of cervical cancer varies across the globe owing to the availability and accessibility of certain equipment, facilities, and personnel. Cervical cancer is often treated using surgical procedures and chemotherapy depending on the stage of tumor growth (Reis et al., 2011). Early-stage tumors may be treated using radiotherapy and chemotherapy drugs, for instance, cisplatin. On the other hand, advanced-stage tumors call for surgical procedures, for instance, trachelectomy and hysterectomy. Trachelectomy is an operation that aims at removing malignant cells while preserving the ovaries and uterus. On the contrary, hysterectomy involves the removal of the entire uterus and a section of the vagina (American Cancer Society, 2016).
Conclusion
Cervical cancer is one of the most prevalent types of cancer in developing countries. Specifically, cervical cancer is ranked second in terms of incidence rate and mortality rate. Nonetheless, the prevalence and mortality rate exhibit significant disparity across the world. The growing burden of this cancer is attributed to several risk factors, including human papillomavirus (HPV), smoking, birth control pills, multiple pregnancies, and immune system deficiency. Cervical cancer can be detected through a Pap test. Also, it can be treated using chemotherapy and surgical procedures.
References
American Cancer Society. (2016). Cervical cancer. Atlanta, GA: American Cancer Society.
Arbyn, M., Castellsague, X., de Sanjose, S., Bruni, L., Saraiya, M., Bray, F., & Ferlay, J. (2011). Worldwide burden of cervical cancer in 2008. Annals of Oncology, 22 (12), 2675-2686.
Cancer. Net. (2016). Cervical cancer: risk factors. Web.
Carson, F. L., & Hladik, C. (2009). Histotechnology: A Self-Instructional Text (3rd ed.). Hong Kong: American Society for Clinical Pathology Press.
Reis, N., Beji, N., & Kilic, D. (2011). Risk factors for cervical cancer: results from a hospital-based case-control study. International Journal of Hematology and Oncology, 21(3), 153-159.