Description
Female reproductive system.
Cervical cancer develops in the narrow part that connects the uterus to the vagina. Almost all cervical cancers are caused by a cervical infection from a certain type of human papillomavirus (HPV), called a high-risk type of HPV. This infection is spread during sex. Most sexually active people will contract an HPV infection during their life time. The infection clears up more often than not within a few months or years, without treatment.
When the infection does not clear up on its own after several years, the virus can infect a number of cells and cause abnormalities on the cervix, called pre-cancerous lesions. Some lesions clear up on their own within a year or two, while others may continue to develop and become cancerous. It may take 10 to 15 years between the time that a person contracts an HPV infection and cancer develops. Some lesions can nevertheless turn into cancer more quickly.
In Québec, in 2019, cervical cancer ranked as the 8th most common cancer in women aged 21 to 65 years. It is ranked as the 3rd most common cancer in women aged 25 to 44 years.
People at risk
Risk factors
Some factors increase the risk of developing cervical cancer. Yet, having a risk factor associated with this type of cancer does not necessarily mean that an individual will get the disease. Normally, a person must have more than one factor for the risk to increase. More rarely, some people will have cancer without having any of its associated risk factors.
The main risk factor associated with cervical cancer is getting a high-risk HPV infection. To find out more, see the page Human papillomavirus (HPV).
Many factors influence the risk of contracting an HPV infection or the ability to clear up the infection. The factors that increase the risk of infection are sexual behaviours that risk exposure to sexually transmitted and blood borne infections (STBBIs), such as:
- sex at a young age
- a large number of sexual partners
- sex with people who have many sexual partners
- sex with people infected with HPV
Factors decreasing the ability to clear up an infection are:
- smoking
- a weak immune system owing to a serious disease or certain medical treatments and medications
- use of oral contraceptives for more than 5 years. However, oral contraceptives greatly reduce the risk of ovarian and endometrial cancer, in addition to preventing unwanted pregnancies.
People with the highest risk of HPV infection should see a healthcare professional to have personalized medical care tailored to their situation.
People who have pre-cancerous lesions or who have already had cervical cancer should also be monitored by a healthcare professional.
Symptoms
Pre-cancerous lesions are usually slow-growing. In fact, these lesions can take up to 10 years or longer to turn into cancer. Very often, people with cervical cancer do not have any symptoms. They may therefore have cancer without knowing it.
However, some people do have symptoms, including irregular vaginal bleeding, especially after penetration, or abnormal vaginal discharge. These symptoms may appear after sex, between menstrual periods and after the start of menopause.
When to see a healthcare professional?
Call Info-Santé 811 or see a doctor if you have abnormal vaginal discharge or bleeding. Note that these symptoms are not necessarily caused by cancer. They may be caused by another health issue.
Vaccination
The best way to reduce the risk of developing and dying from cervical cancer is vaccination. in Québec, two HPV vaccines are offered free to eligible people. People who are not eligible can also get the vaccine but they must pay for it. To find out more, see the page Human papillomavirus (HPV) vaccines.
Screening
Cervical cancer screening is another effective way to reduce the risk of developing and dying from this cancer. Cervical cancer, caused by a persistent HPV infection, very often has no symptoms. A healthcare professional may recommend that an eligible woman undergo screening in the form of a Papanicolaou test (Pap test) or else a test to detect HPV (HPV test).
Cancer screening has advantages and disadvantages. Eligible women can choose whether or not to participate in screening, according to their values and preferences. Screening is an option, never an obligation. To learn more, see the page Cervical cancer screening.
Sexual protection
The use of a condom is also a recommended method to protect yourself against an HPV. Condoms reduce the risk of HPV infection when they are used:
- any time there is genital contact
- throughout any oral, vaginal or anal sex
- every time a person has sex
The use of a latex square (dental dam) to cover the vulva or anus during oral sex reduces the risk of spreading HPVs. It prevents direct contact with the mouth. To make a latex square, unroll a condom, cut off the tip and rim, and cut along the length of the condom.
However, the use of a condom or latex sheet does not prevent the spread of HPVs through contact with infected areas that are not covered, such as the vulva and the scrotum. It is nevertheless important to use a condom to limit the risk of spreading HPVs and other STBBIs.
People who share sex toys can reduce the risk of spreading HPVs by covering the toys with a condom. They must change the condom between partners.
Treatments
When a person has cervical cancer, a team specialized in gynecologic oncology draws up a personalized treatment plan with her. This plan varies according to different aspects, such as the cancer stage, the person’s health and whether or not they want to get pregnant in the future. The plan also takes into account their wishes and concerns, as well as their family’s.
The main treatments offered to people with cervical cancer are:
- surgery
- radiation therapy
- immunotherapy, targeted therapy or chemotherapy.
In some cases, only one of these treatments is necessary. In other cases, the medical specialist may recommend a combination of several of these treatments.
Last update: November 6, 2023
