Overview



Please note that information in this section is intended as educational information only, and is geared towards sexually active individuals with a vagina. Please see the resources section for links to additional information, and sources of medical advice.

Cervical cancer is a cancer of the cervix. The cervix is a cylinder shaped area connecting the vagina and the uterus.

Different types of infections can be passed through various contact types such as:


Cervical cancer generally develops over a long period of time, and is caused by persistent (won’t go away) infections with high risk strains of HPV. With early detection, cervical cancer is one of the most successfully treatable cancers and a person's chances of surviving is very good.


Four women a day will develop cervical cancer


One woman a day will die of cervical cancer


One in three women do not screen regulatory for cervical cancer

In Canada, there are still 1,500 people who are diagnosed with cervical cancer every year, and 400 of those people will die. Screening is very important to preventing cervical cancer, but about one in three Canadians who should be screening don’t screen regularly.

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Pap vs. HPV test



When screening for cervical cancer, there are two different tests are often used.


CYTOLOGY (PAP TEST)


The commonly known test is called cytology, which is also known as the Pap test. During a pap test, a healthcare professional collects cells from inside of the cervix which are observed under a microscope by a Cytologist. The Cytologist will determine if the cells look abnormal, which could indicate cervical pre-cancer or cancer.


Samples collected from inside the cervix

Cells observed to detect cell abnormalities

HPV TEST


In an HPV test, a sample is collected from inside the vagina close to the cervix. The sample is processed for high risk HPV DNA on a molecular diagnostic machine. If HPV DNA virus is present, then an infection is confirmed. Because cervical cancer is caused by high risk strains of HPV, if there is no HPV infection, that person is very unlikely to develop cervical cancer in the near future. It is recommended for people only over the age of 30 to take an HPV test as HPV is very common in younger people, but usually goes away on its own. It is more common that people over 30 years of age who test positive have a persistent HPV infection and therefore at potential risk for pre-cancer or cancer.


Samples collected from around cervix

Detection of HPV DNA on molecular diagnostic machine

The HPV and cytology tests are often used in combination to prevent cervical cancer. If a cytologist is not sure whether cervical cells are abnormal, they may use an HPV test to confirm if the virus is present.

If an HPV test is positive, a Pap test is recommended to check if any cellular changes have occurred.

Having a positive HPV or cytology test does not mean the person has pre-cancer or cancer. But it does mean there is potential risk, which should be monitored.

For information on your provinces/territories screening guidelines, click here.

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Risks



There are certain risk factors that have been identified that may increase someone’s risk for developing cervical cancer. Infection with HPV is the most important risk factor.

Known risk factors include:


HPV infection

Smoking

Giving birth multiple times

Sexual activity

Weakened immune system

Socio-economic status

Long term oral contraceptives

Cervical cancer in family history

History of stis

Most cases of cervical cancer occur in people younger than 50 years of age, and may affect people of African ancestry more often than Caucasian people. People of certain religions also tend to have lower rates of cervical cancer, but likely due to having fewer sexual partners, which can lower their exposure to HPV.

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Symptoms



Earlier stage symptoms of cervical cancer may include:



Unusual Bleeding
  • • Bleeding after sex
  • • Bleeding after menopause
  • • Bleeding after a pelvic exam
  • • Bleeding after vaginal douching

Unusual Discharge
  • • Pale, watery, pink or brown discharge in between period
  • • Increased amount of discharge
  • • Usually smelly discharge
  • • Bloody discharge

Unusual Menstruation
  • • Usually long or heavy periods

Unusual Pain
  • • Pain during sex

Later stage symptoms may include:


Urination Issues
  • • Difficulty urinating
  • • Loss of bladder control
  • • Blood in the urine
  • • Leaking of urine from the vagina

Bowel Issues
  • • Constipation
  • • Blood in the stool
  • • Leaking of feces from the vagina

Pain or swelling
  • • Pain in the pelvic area or lower back
  • • Pain may go down the leg or legs
  • • Bone pain
  • • Swelling in the legs

Other Issues
  • • Anemia (low red blood cells)
  • • Weight loss or loss of appetite
  • • Shortness of breath
  • • Fatigue

You should see a doctor if you begin to experience these symptoms, even if your HPV test came back negative. Even if these symptoms are not present, screening on a regular basis is a good idea.

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Stages



Pre-Cancer


At the pre-cancer stage, cervical cells can develop abnormal changes. These abnormal cells do not always develop into cervical cancer (sometimes they change back to normal on their own), but they have a higher risk than normal cells of doing so.

Precancerous changes in the cervix are quite common, and it usually takes many years for a pre-cancer to develop into cancer. Most people who are treated for cervical pre-cancer will not develop cancer. Treatment for pre-cancer usually involves removing abnormal cells from the cervix.


Normal


Mild Abnormal


Severe Abnormal


Cancer



Cervical Cancer


When abnormal cells progress to cervical cancer, doctors may grade the cancer according to how severe it is. The type of treatment offered may differ according to the grade (or severity) of the cancer. Treatment could include surgery, chemoraditation, or radiation. The lower the grade of cervical cancer, the higher the patient’s chances of surviving is (prognosis).

Screening


Because of the long development time between pre-cancer and cancer, and a very good prognosis with treatment at the early stages of cervical cancer, this disease is very preventable. But screening is critical to ensuring prevention and early treatment if necessary.

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