The cervix has two parts endocervix and exocervix. Each of these cervix parts has two different cells.
Endocervix is the entrance of the uterus covered with glandular cells. Exocervix is the external part of the cervix covered with squamous cells. Doctors physically check this part in a speculum exam.
Both endocervix and exocervix meet at the transformation zone. The location of the transformation zone alters after giving birth and the aging process. The cells present in the transformation zone are the site of cervical cancer progression.
However, cells present in the transformation zone do not abruptly turn to cancerous growth. A gradual abnormality occurs in the normal cells of the cervix. This phase is termed a pre-cancerous condition. A doctor can interpret these changes as cervical intraepithelial neoplasia (CIN), dysplasia, and squamous intraepithelial lesion (SIL).
Laboratory-based diagnosis at pre-cancerous stage based on grades 1 to 3 that based on the abnormality of cervical tissue. Cervical intraepithelial neoplasia -1 condition is a mild mild dysplasia or described as low-grade SIL. In this condition, abnormality of tissue is noticeable, but less serious cervical pre-cancer. Cervical intraepithelial neoplasia 2 and 3 are high-grade SIL or moderate to severe dysplasia. A significant amount of abnormality is noticeable and considered as a most serious pre-cancerous stage.
It is necessary to mention that most pre-cancerous changes in the cervix rarely turn to cervical cancer as it can go away even no treatment requires some time. But fewer cases, pre-cancerous cells turn to invasive cervical cancer. Early diagnosis and immediate treatment can prevent the conversion of cervical pre-cancers to cervical cancers formation.
The screening of pre-cancer or early cancer stage is the main goal to cure and treat cervical cancer. Medically it is always suggested for periodic cervical cancer screening test to prevent this disease and saves a life. The HPV test and the Pap test are two cervical cancer screening tests that are widely available in almost all the hospital and clinic set-ups to detect pre-cancerous changes. The HPV test is performed to detect the high-risk types of HPV infection in the cervix. This infection has no treatment available, but vaccination can prevent the condition. A Pap test can detect the precancerous growth in the cervix.
Types of cervical cancer
Depending upon the histological findings in the laboratory, cervical pre-cancers, and cervical cancers are two types – squamous cell carcinoma and adenocarcinoma.
Squamous cell carcinoma is the most common type of cervical cancer. Usually, the exocervix is the starting point of squamous cell carcinomas development, and gradually untreated conditions spread into the transformation zone. It has been found almost up to 9 out of 10 cervix cancer patients have Squamous cell carcinoma.
The remaining cervix cancer incidences are mostly adenocarcinomas. Glandular cells are affected in adenocarcinomas. Endocervix containing mucus-producing gland cells are the starting point of cervical adenocarcinoma.
In a rare instance, adenosquamous carcinomas or mixed carcinomas are detected that have both squamous cell carcinomas and adenocarcinomas.
Apart from these, metastatic melanoma, metastatic sarcoma, and metastatic lymphoma can also spread to the cervix and cause cervical cancers.
Sign and symptoms
The early stage of cervical cancer is asymptomatic. But the advanced stage has the following sign and symptoms:
- Vaginal bleeding after intercourse,
- Vaginal bleeding started between periods or after menopause
- Foul odor watery, bloody vaginal heavy discharge.
- Pelvic pain
- Pain during intercourse
Risk factors
Following are some risk factors that trigger cervical cancer:
- Multiple sexual partners increase the risk of HPV.
- Sexual activity at a very early age also increases HPV.
- Sexually transmitted infections (STIs) like chlamydia, gonorrhea, syphilis, and HIV/AIDS can increase HPV risk.
- A weak immune system because of other health conditions can influence HPV invasion.
- Smoking has a link with squamous cell cervical cancer.
- Side effects of some medications like diethylstilbestrol exposure to prevent miscarriage may increase the risk of a certain type of cervical cancer called clear cell adenocarcinoma.
Prevention
Following are certain preventive measures for cervical cancer :
- Immunization of HPV vaccine
- Performing routine Pap test
- Necessary actions for safe sex
- Avoid smoking
