Cervical Cancer Prevention

Introduction

Cervical cancer – characterised by malignant tumours that develop in the cervix – is a significant health concern for people assigned female at birth (AFAB) worldwide. The cervix, located at the lower part of the uterus, plays a crucial role in reproductive health. Cervical cancer typically develops slowly over time, often beginning with precancerous changes that can be detected through routine screenings. Understanding cervical cancer and its prevention is essential for reducing its incidence and improving health outcomes.

Explanation of cervical cancer

Cervical cancer emerges from the irregular development and multiplication of cells in the cervix, which can invade surrounding tissues or spread to other parts of the body. The principal cause of cervical cancer is persistent infection with high-risk strains of human papillomavirus (HPV).

HPV is a common sexually transmitted infection, and while most HPV infections clear up on their own, some can lead to the development of cervical cancer. Symptoms of cervical cancer can involve irregular vaginal bleeding, pelvic pain, and pain during intercourse. Still, early stages of the disease are often asymptomatic (ie. shows no symptoms), highlighting the importance of regular screening.

Importance of prevention

Preventing cervical cancer is crucial because it can significantly reduce the morbidity and mortality associated with the disease. Prevention strategies include HPV vaccinations, regular cervical screenings, and practising safe sex. The HPV vaccine is highly effective in preventing infections with the types of HPV most commonly associated with cervical cancer.

Regular screenings can detect precancerous changes in the cervix, allowing for early intervention and treatment before cancer develops. By adopting these preventive measures, individuals can protect themselves and help achieve the broader public health goal of reducing cervical cancer rates.

Risk factors for cervical cancer

Human papillomavirus (HPV) infection

Cervical cancer remains a significant public health concern, but understanding its associated risk factors can lead to effective prevention strategies. One of the primary risk factors is HPV infection. This group of viruses includes certain strains, such as HPV-16 and HPV-18, which are most commonly linked to cervical cancer.

Studies have shown that persistent infection with these high-risk HPV types can lead to the development of precancerous lesions and, eventually, cervical cancer.¹ Studies have also shown that HPV vaccinations are effective in preventing infections with HPV strains linked to cervical cancer.

These vaccines have been proven to significantly reduce the incidence of these infections – with the efficacy being 91.6% against incident infection and 100% against persistent infection with HPV-16 and HPV-18 – thereby lowering the risk of cervical cancer.² 

Smoking

Smoking is another critical risk factor for cervical cancer. Carcinogens (cancer-causing substances) in tobacco smoke can damage the DNA of cervical cells, enhancing their susceptibility to HPV infection and subsequent cancerous changes. Research has found that people AFAB who smoke are about twice as likely to develop cervical cancer compared to non-smokers.³ This highlights the importance of smoking cessation programs as part of cervical cancer prevention efforts.

Weakened immune system

A weakened immune system can also raise the risk of cervical cancer. Conditions such as HIV/AIDS or the use of immunosuppressive drugs can impair the body's ability to fight off HPV infections. Research indicates that people AFAB with compromised immune systems are at a higher risk of developing cervical cancer, emphasising the need for regular monitoring and preventive measures in these populations.⁴

Early sexual activity

Early sexual activity is another prominent risk factor as it increases the likelihood of HPV infection. The cervix is more susceptible to HPV during adolescence, and early sexual activity can expose young people AFAB to the virus before their immune systems are fully developed. A study found that the risk of HPV infection is higher in people AFAB who begin sexual activity at a younger age. This highlights the importance of sexual education and HPV vaccination before the onset of sexual activity.⁵

Multiple sexual partners

Having multiple sexual partners increases the risk of HPV infection, as it raises the likelihood of encountering an infected partner. A statistical analysis of multiple studies (known as a meta-analysis) has demonstrated a strong correlation between the number of sexual partners and the risk of cervical cancer.⁶ This finding supports the promotion of safe sexual practices and the use of barrier methods to reduce HPV transmission.

Lack of regular cervical cancer screening

Finally, the lack of frequent cervical cancer screening is a significant risk factor for the development of the disease. Cervical screening (formerly known as a smear test in the UK) can detect precancerous changes in the cervix, allowing for early intervention and treatment. A study found that regular cervical screening significantly reduces the incidence and mortality of cervical cancer.⁷ Therefore, increasing access to and awareness of cervical cancer screening is crucial for prevention.

Prevention methods

Vaccination against HPV

One of the most effective ways to prevent cervical cancer is through vaccination against the human papillomavirus (HPV), which is responsible for the majority of cervical cancer cases. Several types of HPV vaccines are available, including Gardasil, Gardasil 9, and Cervarix. These vaccines protect against the most common cancer-causing strains of HPV.

The recommended age for vaccination in the UK is between 11 and 12 years, but it can be administered as young as age nine and up to age 26 for those who missed their initial vaccination window. The effectiveness of these vaccines is well-documented, with studies showing a significant reduction in the incidence of HPV infections and related cervical abnormalities.²

Safe sexual practices

Practicing safe sex is another crucial component of cervical cancer prevention. The use of condoms can significantly reduce HPV transmission, although it does not eliminate the risk. Limiting the number of sexual partners is another way of reducing the likelihood of HPV exposure. Open and honest communication with sexual partners about sexual wellbeing and history is key for mutual protection and informed decision-making. These practices collectively contribute to a lower risk of contracting HPV and, consequently, cervical cancer.

Regular cervical cancer screening

Regular screening for cervical cancer is vital for early detection and successful treatment. In the UK, cervical screening involves initially testing the cervical cells for the presence of high-risk HPV strains (the HPV test). If high-risk HPV is identified, the sample will then be tested for changes to the cervical cells. In the UK, all people AFAB aged between 25 and 64 years are invited to attend cervical screening. It is recommended that everyone with a cervix attends screening every three years if aged 25 to 49 and every five years from age 50 to 64. Early detection through cervical screening allows for timely intervention and significantly increases the chances of successful treatment.

Lifestyle changes

Incorporating healthy habits into your lifestyle can also play a significant role in preventing cervical cancer. Quitting smoking is particularly important, as smoking has been linked to an increased risk of cervical cancer.

Maintaining a healthy diet rich in fruits, vegetables, and whole grains can support overall immune function and reduce cancer risk. Another key factor is regular exercise, as it helps maintain a healthy weight and boosts the immune system. These lifestyle changes not only contribute to overall well-being but also enhance the body's ability to fight off infections, including HPV.

Importance of early detection

Explanation of early detection

Early detection of cervical cancer involves identifying precancerous changes or early-stage cancer in the cervix before symptoms appear. This is achieved through regular cervical screening that screens for high-risk HPV types that are most likely to cause cervical cancer, as well as abnormal cells in the cervix that have the potential to develop into cancer. By catching these abnormalities early, healthcare providers can intervene promptly, often preventing the progression of invasive cancer.

Impact on treatment success

The impact of early identification on treatment success cannot be overstated. When cervical cancer is identified at an early stage, it is generally more treatable and the range of treatment options is broader and less invasive. Early-stage cervical cancer can often be managed with procedures including simple excisions of abnormal tissue, cryotherapy, or laser therapy.

In contrast, late-stage cervical cancer may require more aggressive treatments like radical hysterectomy, radiation therapy, and chemotherapy, which come with higher risks and more severe side effects. Early detection not only improves the likelihood of successful treatment but also enhances the quality of life for patients by reducing the need for extensive medical interventions.

Statistics on survival rates for early vs. late-stage cervical cancer

Statistics underscore the central importance of early detection in improving survival rates for cervical cancer. According to data from various cancer research organisations, the five-year survival rate for women diagnosed with early-stage cervical cancer is approximately 92%.⁸ This high survival rate is attributed to the effectiveness of early treatment interventions.

Conversely, the five-year survival rate drops significantly for those diagnosed at a later stage, with advanced (i.e. metastatic) cervical cancer having a survival rate of around 17%.⁸ These stark differences in survival rates highlight the life-saving potential of regular screening and early detection, emphasising the need for widespread awareness and accessibility to cervical cancer screening programs.

Summary 

Cervical cancer is a significant health concern for women worldwide and understanding its causes, symptoms, and prevention methods is crucial for improving women's health outcomes. Cervical cancer arises from the abnormal growth of cells in the cervix, primarily caused by persistent infection with high-risk types of HPV. 

Prevention strategies such as HPV vaccination, regular cervical screening, and safe sex practices are essential in reducing the risk of developing cervical cancer. Risk factors such as smoking, weakened immune systems, early sexual activity, and multiple sexual partners increase the likelihood of HPV infection and highlight the importance of preventive measures.

Regular cervical cancer screening is also crucial in detecting precancerous changes and allowing for early intervention and treatment. By implementing these preventive measures, individuals can protect themselves and contribute to the broader public health goal of reducing cervical cancer rates.