Cervical cancer is among the leading causes of mortality in women. Cervical cancer was first mentioned by Hippocrates (Greece), he described the disease and found it incurable. With invention of colposcope by Dr Hinselmann in 1925, the doctors become able to examine the cervix and detect the early stages of cancer. Timely diagnostics allowed surgery interventions to be successful. In 1928, Georgios Papanikolaou improved cervical cancer diagnostics through enabling identification of cervical cells abnormalities. “Papanikolaou-smear” or “pap-smear”, based on liquid based cytology, after its inception (1943) became the widespread form of diagnostics of cervical cancer and preceeding abnormalities because of it’s efficiency – about 92% of all cases detected by pap-smear prior to symptoms can be cured successfully.
All the adult women are exposed to the threat of cervical cancer, but in the majority of cases cervical cancer occurs between forty and forty-nine years of age (Berria, 2013.) In recent years, there’s a trend for cervical cancer to occur in younder women. Most cases are detected in women younger than 50, about 15% of all cases – in women over 65. This type of cancer rarely develops in women younger than 20 (American Cancer Society, 2014.)
In most cases, the cervical cancer starts from the transformation zone cells. The cancer is preceeded by pre-cancerous changes: cervical intraepithelial neoplasia, squamous intraepithelial lesion, and dysplasia, that gradually develop into cancer (American Cancer Society, 2014.) About 90% of cervical cancers are classified as squamous cell carcinomas, others are adenocarcinomas or mixed carcinomas.
According to United States Cancer Statistics, 5-year survival rate for cancer of cervix uteri accounts for 67.5%. Actually, prognosis for specific patient depends on the stage of cancer type of treatment applied. The five-year survival rate for women with surgical removal of the tumor is up to 90 percent; for patients with radiation therapy the cure rates are 75-90 percent (Berria, 2013.)
The major factors involved in initiating cervical cancer: young age at first intercourse; tobacco smoking; ultiple sexual partners; sexually transmitted infections such as herpes simplex (type 2) and human papillomavirus (Berria, 2013.)
Harald zur Hausen, MD, a German scientist, has won the Nobel Prize for discovering the family of viruses playing a key a role in development of cervical cancer. It’s human papilloma virus (HPV), types 16 and 18, these strains “are responsible for about 70% of cervical cancers worldwide” (American Cancer Society, 2008.) Large number of sexual partners (over 4) proved by various studies to be the major risk factor for HPV infection and, thus, for cervical cancer; anpther studies show that the risk “of HPV infection, the development of CIN lesions, and cervical cancer increase with the number of sexual partners (Szaboova,Svlhrova, and Hudeckova, 2014.)
The cofactors of cervical cancer include hormonal factors (higher number of childbirths or hormonal contraceptive use), immune system deficiency states (HIV, oncological diseases), presence of sexually transmitted diseases like Chlamydia trachomatis, nutritional factors, and various metabolic disorders (Szaboova,Svlhrova, and Hudeckova, 2014.)
In 2008, cervical cancer is was the seventh most deadly cancer worldwide, resulting in 275 thousand women deaths, as World Health Organization data show (Berria, 2013.) According to American Cancer Society's data, there’re 12,360 new cases of invasive cervical cancer to be diagnosed in 2014; over 4,000 women are expected to die from cervical cancer. Due to widespread screening programs, cervical cancer incidence rate decreases gradually (between 2007 and 2012 it went down by 1.9% a year, according to Benard et.al, 2014.)
There’re several factors that, according to the researches, can reduce risk of cervical cancer. Those are the following: healthy diet (reducing fat intake, eating high-fiber foods, fruits and vegetables); regular checkups (including pap-smear); quitting smoking; safer sexual lifestyle; using barrier methods of contraception (Berria, 2013.)
References:
- Berria, M. (2013). Cervical, ovarian, and uterine cancers. Magill’s Medical Guide, January, 2013
- Szaboova, L., Svlhrova, V. and Hudeckova, V. (2014). Selected Risk Factors for Cervical Cancer and Barriers to Cervical Cancer Screening. Acta Medica Martiniana. Sep2014, Vol. 14 Issue 2, p25-30. 6p.
- Benard, V., Thomas, C., King, J., Massetti, G., Doria-Rose, V. and Saraiya, M. (2014). Vital Signs: Cervical Cancer Incidence, Mortality, and Screening -- United States, 2007-2012. MMWR: Morbidity & Mortality Weekly Report. 11/7/2014, Vol. 63 Issue 44, p1004-1009. 6p.
- American Cancer Society (2014). What is cervical cancer? Retrieved from http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-what-is-cervical-cancer
- American Cancer Society (2008). Nobel Prize for Discovery of Cervical Cancer Virus. Retrieved from http://www.cancer.org/cancer/news/nobel-prize-for-discovery-of-cervical-cancer-virus
- United States Cancer Statistics (USCS 5-Year Relative Survival by Selected Primary Site, Race, Sex, and Age Group - National Program of Cancer Registries, United States. http://apps.nccd.cdc.gov/uscs/Survival/Relative_Survival_Tables.pdf .
