Cervical cancer

Nearly all cervical cancers are caused by infection with the human papillomavirus (HPV). This virus infects cells on the cervix and causes changes that over time can lead to cancer. Knowing what can cause this cancer has been a valuable tool for medical researchers and scientists in terms of helping to prevent women from dying from cervical cancer.

In New Zealand, the combination of a successful cervical screening programme (regular smear testing) as well as a vaccination programme to protect young people against HPV, means that the risk of dying from cervical cancer is markedly reduced compared to other cancers. Cervical cancer usually grows very slowly. If caught at an early stage it is very treatable, but it can be a serious disease if allowed to grow bigger or spread into surrounding tissues. In New Zealand there are still around 160 women diagnosed with cervical cancer each year, and about 50 of these women will die from it. Cervical cancer can affect anyone with a cervix. This includes women, non-binary people, trans men or intersex people. If you have had a total hysterectomy where your womb and cervix have been removed you cannot get cervical cancer.

You can get infected with HPV from sexual activity. There are several strains of the virus, some of which are higher risk and can cause different types of cancer such as head, neck, cervical, anal and vulval cancers. Other strains can cause genital warts. HPV infection is very common, with up to 80% of adults being infected at some point in their lives.

The HPV vaccination programme started in 2008 and is for people aged 9 to 26 years old. The vaccine protects against some of the higher risk HPV strains that can cause cervical cancer. Having the full course of the vaccine helps to protect people from developing HPV infection and therefore decreases the risk of cervical cancer and other diseases caused by HPV. Children in Year 8 at school are offered the vaccination through a school-based immunisation programme (and it is also available through your GP, health centres and some Family Planning Clinics).

Regular smear tests can detect changes on the cervix before they turn into cancer. It is very important that smear tests are done at least every three years, or more often if you have a confirmed HPV infection or have had abnormalities picked up in a previous test.

Usually, there are no symptoms in the pre-cancerous and early stages of cervical cancer. It is often only when the cancer has gone undetected for some time and has grown into surrounding tissue, that symptoms start to occur. Symptoms to look out for are:

• abnormal vaginal bleeding (after sex, bleeding or spotting between periods, heavier, longer periods, or bleeding if you have been through menopause)
• pain in the pelvic area (tummy, pelvis, lower back)
• pain after sex
• unusual vaginal discharge
• blood in the urine
• problems urinating or having a bowel motion.

While regular cervical screening and HPV vaccination are the best means of prevention against cervical cancer, other prevention measures are using condoms during sex, stopping smoking (as it weakens your immune system), and eating a balanced diet to support your immune system. Treatment for cervical cancer depends on what stage it is found and can involve surgery, radiotherapy and/or chemotherapy. Early-stage cancer is usually treated with surgery. A procedure called a cone biopsy cuts away the small area of cancerous tissue, leaving the rest of the cervix intact. This way, you can still become pregnant in the future. More invasive surgeries may be required which can involve removal of the cervix and surrounding tissue, or even a hysterectomy where the cervix and uterus are removed. Radiation therapy is often used as the primary treatment along with chemotherapy for locally advanced cervical cancer to kill cancer cells. These treatments can also be used after surgery if there is a chance that the cancer could come back.

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.