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About Cervical Cancer
Current estimates indicate that over 10 000 women in South Africa are diagnosed with cervical cancer each year with just over half that number succumbing to the disease. These statistics rank cervical cancer as the 2nd most common cancer overall among women in South Africa (second only to breast cancer) and the most common cancer among women between the ages
of 15 and 44.
Cervical cancer starts in a female’s cervix, which connects the vagina (birthing canal) and the uterus (womb). The cervix has two surface types; the outer (ectocervix) that opens into the vagina and an inner surface that lines the cervix canal (endocervix).
Each surface type has different cell types; the ectocervix, the outer surface, is covered in squamous cells where the inner surface, the endocervix) is covered in Glandular cells. The area where these two cell types meet is called the Transformation Zone, where most Cervical Cancer starts.
There are two main types of cervical cancer which start in the cell types mentioned above. The most common cervical cancer (around 70% of cases) begins in the squamous cells and is known as squamous cell carcinoma (SCC). The second type is Adenocarcinoma, which is responsible for about 25% of all cervical cancer cases and begins in the glandular cells of the
cervix. As the glandular cells are found higher up in the cervix, it is harder to diagnose adenocarcinoma.
Causes of Cervical Cancer
According to the National Cervical Cancer Coalition, Human Papillomavirus (HPV) is responsible for 91% of all cervical cancer cases. While HPV is the most common cause, it is important to note that there are many types of the HPV viruses and most people that have HPV do not develop Cervical Cancer.
Although HPV can be found in males and females, cervical cancer only affects females, transgender men, and intersex people.
According to the Centre for Disease Control and Prevention, the below can increase your chances of getting cervical cancer:
● Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems. This is because your immune system can usually fight off the HPV virus.
● Smoking – Chemicals found in tobacco can damage cells in the cervix which makes it easier for cancer to develop in people with HPV.
● Using birth control pills for a long time (five or more years). The reason for this is not clear, however, according to the Cancer Council of Australia, the risk is small and birth control pills can prevent other types of cancer such as uterine and ovarian cancers.
● Having given birth to three or more children. The reason for this is also not clear, however, according to the American Cancer Society, this could be either due to the increase of sexual partners, hormonal changes, or a lower immune system from
● Having several sexual partners. By having multiple sexual partners, you increase your chances of getting HPV as this is a sexually transmitted disease.
Symptoms of Cervical Cancer
Precancerous and early cervical cancer cells do not usually have any symptoms. Symptoms that do appear are quite common and usually appear in other conditions such as urinary tract infections, fibroids, or endometriosis.
Common symptoms associated with cervical cancer are:
● Unusual vaginal bleeding; between periods, during or after sex, and after menopause.
● Pain during sex.
● Change to vaginal discharge, i.e. more discharge than usual or an unusual smell or colour.
● Pain in your lower back, between your hip bones (pelvis), or in your lower tummy.
● Increased or painful urination.
See a doctor if you are worried or if the symptoms are ongoing. The Cancer Council notes that “this is important for anyone with a cervix, whether straight, lesbian, gay, bisexual, transgender or intersex, even if you are up to date with cervical screening tests.”
Get an HPV vaccine
According to the CDC, the HPV vaccine has the potential to prevent more than 90% of HPV attributable cancers. The HPV vaccination is given to boys and girls from age 9 – 26 to prevent HPV; the vaccine will only help prevent HPV and will not treat an HPV infection.
It is best to get the vaccine as young as possible, between 9 – 12, to reduce the likelihood of being already exposed to HPV as well as having a better immune response to the vaccine.
Limit exposure to HPV
HPV is passed through exposure/skin-to-skin contact with an area of the body that is infected with HPV. It is, therefore, possible to spread HPV without sex, however, it is most commonly spread through contact during sex such as vaginal, anal, and oral sex. It can also spread through hand-to-genital contact.
The best way to limit your exposure to HPV is to abstain from sex or limit the number of sexual partners you have as well as reduce having partners that have has multiple sexual partners.
Use a condom
Using a condom cannot fully prevent the spread of HPV and it does not cover the entire genital area but it can reduce the chances of getting HPV as well as prevent a host of other STDs and pregnancy.
As previously mentioned, smoking damages cervical cells that increase your chances of getting cervical cancer. It is best to avoid smoking to reduce your risk of getting Cervical and other types of cancer.
The two screening tests that can be performed to determine if you have Cervical Cancer are the Pap test and the HPV test which can be tested separately or together. Both tests are performed the same way where a health professional uses a special tool to remove cells from the cervix by gently scraping or brushing the cervix.
According to the American Cancer Society, the HPV test looks for an HPV infection in the cells by high-risk HPV types whereas the Pap test looks for any cell changes or abnormal cells.
Based on the results of your tests, your doctor will recommend how often you should go for these tests, however, you should go for a pap test at least every 3 years and an HPV test at least every 5 years.
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