Bangkok--15 May--Bumrungrad International
What is cervical cancer?
Cervical cancer — one of around 200 different types of cancer — develops in the cervix, the cone-shaped part of the uterus that
connects the upper part of the uterus (the womb) and the vagina .
Cervical cancer develops when abnormal cells in the lining of the cervix begin to multiply out of control in response to HPV
infection . Abnormal cervical cells can gather to form a lump called a tumor. Benign (non-cancerous) tumors do not spread and usually are
not harmful. Malignant (cancerous) tumors, however, spread from their sources and grow into life-threatening cancer .
What causes cervical cancer?
Virtually all cervical cancers are caused by some type of human papillomavirus (HPV) , a common virus that infects about half of
all people at some point in their lives .
More than two-thirds of cervical cancer cases are attributed to high-risk HPV types 16 and 18 .
In an international study of women (n=1050) with cervical cancer in 22 countries, more than 90 percent of the women in South Asia
(India, Indonesia, Philippines and Thailand) were infected with HPV, primarily types 16 and 18.
In separate studies in Thailand (n=338) and the Philippines (356) , nearly 90 percent of the women with cervical cancer were also
infected with HPV with types 16 and 18 being the most common.
Another study in Hong Kong (n=332) among women with abnormal Pap tests found HPV infection in 44 percent of women overall; among
those with cervical cancer, nearly 80 percent were infected with HPV .
How common is cervical cancer?
Worldwide, cervical cancer is the second-most common cancer affecting women and the second-leading cause of cancer death in women
.
Nearly 500,000 new cases of cervical cancer were reported worldwide in 2002, the last year for which data are available, with
about 275,000 deaths from the disease . Almost 80 percent of all cervical cancer cases occur in the developing world ,
The prevalence of cervical cancer is estimated to be 1.4 million cases worldwide .
In the Asia Pacific region, cervical cancer ranks second only to breast cancer as the most common cancer among women. It is the
fourth most common cause of cancer-related death in women in the region .
For 2002, there were more than 100,000 new cases of cervical cancer and about 53,000 deaths from the disease in women in
South-Eastern and Eastern Asia. The data by country are :
Country Number of New Cases Deaths
? China ? 45689 ? 25561
? Indonesia ? 15050 ? 7566
? Japan ? 7772 ? 3573
? Philippines ? 6000 ? 4349
? Thailand ? 6243 ? 2620
? Vietnam ? 6224 ? 3334
? Myanmar ? 5017 ? 2594
? Korea, Republic of ? 4949 ? 1327
? Korea, Democratic Republic of ? 2150 ? 558
? Cambodia ? 1768 ? 949
? Malaysia ? 1492 ? 766
? Singapore ? 323 ? 205
? Laos ? 317 ? 159
? Mongolia ? 171 ? 92
? Brunei ? 26 ? 13
Who gets cervical cancer?
Cervical cancer tends to occur in women in their 40s and 50s , when many are still raising children and contributing to their
families’ livelihoods and security .
Women in underserved communities are less likely to undergo recommended cervical cancer screening, which could account for the
greater risk for cervical cancer among these groups
How is cervical cancer diagnosed?
The Pap test (also called Pap smear) is a simple test — usually conducted in a doctor’s office or clinic — that detects abnormal
or cancerous cervical cells .
Because the Pap test can detect cervical changes before they progress to cancer , it is credited with significantly reducing
cervical cancer deaths since its widespread use began in the 1950s . Between 1950 and 1970, the number of cervical cancer deaths in the
United States decreased 70 percent . (or insert relevant country statistic)
Like other medical tests, however, Pap tests aren’t perfect . Sometimes they do not find cervical abnormalities that actually
exist — but regular screening can help women and their healthcare providers overcome these “false-negative” screenings .
In addition, Pap tests can sometimes show minor cervical abnormalities that are due to infection with low-risk HPV types such as
types 6 and 11 . These results can be costly for the health system , but more importantly, may cause unnecessary anxiety for the patient .
What are the symptoms of cervical cancer?
Precancerous changes and early cancers of the cervix generally do not cause pain or other symptoms ; therefore, it is important to
get regular Pap screenings to detect cervical pre-cancers or cancers at a stage when they can be treated most effectively .
As the disease progresses, women may notice one or more of the following symptoms:
Abnormal vaginal bleeding :
Bleeding that occurs between regular menstrual periods
Bleeding after sexual intercourse, douching or a pelvic exam
Menstrual periods that last longer and are heavier than before
Bleeding after menopause
Increased vaginal discharge
Pelvic pain
Pain during sexual intercourse
How are cervical cancer and pre-cancer treated?
There are a number of treatment options available for cancerous and pre-cancerous cervical lesions. In each case, a woman and her
healthcare provider determine the most appropriate treatment.
Pre-invasive stage (Stage 0 — Carcinoma in Situ) - When the cancer has affected only the outer layer of the lining of the cervix ,
treatment may include:
Laser surgery uses a laser beam to destroy abnormal cells .
Cryosurgery destroys cancerous and pre-cancerous lesions by freezing them .
Loop electrosurgical excision procedure (LEEP) uses a thin wire loop (through which an electrical current is passed) to cut away
an area of abnormal cells from the cervix .
Conization surgically removes a cone-shaped piece of tissue from the cervix.
Invasive stage (Stages 1-4 )- When the cancer has penetrated into the cervix and possibly to other tissues and organs , treatment
may include:
Radiation uses high-energy rays to shrink tumors by destroying the cancer cells’ ability to reproduce .
Chemotherapy uses anticancer drugs which reach all areas of the body to kill cancer cells, including those that have spread to
distant organs .
Hysterectomy can be performed two ways, depending on the extent of the cancer: 1) Simple hysterectomy is the removal of the
cancer, the cervix and the uterus . 2) Radical hysterectomy involves the removal of the cervix, the uterus, part of the vagina and lymph
nodes in the area .
How can cervical cancer be prevented?
Cervical cancer can usually be prevented if women are screened regularly with Pap tests. Women should talk to their healthcare
providers about having regular Pap screening tests and discuss results with them.