Cervical Cancer: Causes, Screening, Prevention, and Treatment

Intro

Cervical cancer is a cancer that develops in the cells of the cervix—the lower part of the uterus that connects to the vagina. It is one of the most preventable cancers in modern medicine, yet it continues to cause significant illness and death worldwide.

The vast majority of cervical cancer cases are caused by persistent infection with human papillomavirus (HPV). Because cervical cancer usually develops slowly over many years, screening and early treatment can stop the disease before cancer ever forms.

Key Points

Over 99% of cervical cancers are linked to persistent high-risk HPV infection
Cervical cancer usually develops slowly over 10–15 years
Screening detects precancerous changes long before symptoms appear
HPV vaccination dramatically reduces lifetime risk
Early-stage cervical cancer is highly treatable

Background

The cervix plays a critical role in reproduction, but it is also uniquely vulnerable to HPV infection. HPV is extremely common—most sexually active people will encounter it at some point in their lives.

In most cases, the immune system clears HPV naturally. When it does not, the virus can cause gradual cellular changes that may progress from precancer → cancer if left untreated.

This long window makes cervical cancer particularly suitable for prevention through routine screening.

Causes and Risk Factors

Primary Cause

Persistent infection with high-risk HPV types, especially HPV-16 and HPV-18

Additional Risk Factors

Not participating in regular cervical screening
Smoking (reduces immune clearance of HPV)
Early onset of sexual activity
Multiple sexual partners (increases HPV exposure risk)
Long-term oral contraceptive use
Immunosuppression (e.g. HIV, organ transplant, chemotherapy)

Screening and Diagnosis

Screening Tests

Pap smear (cytology): looks for abnormal cervical cells
HPV test: detects DNA from high-risk HPV strains
Co-testing: combines Pap smear and HPV testing (used in some regions)

Many countries are transitioning to primary HPV testing, as it detects cancer risk earlier than cytology alone.

Diagnostic Follow-Up

If screening results are abnormal:

Colposcopy (magnified examination of the cervix)
Cervical biopsy to confirm diagnosis
Imaging for staging if cancer is suspected

Treatment Options

Treatment depends on the stage of disease, age, fertility considerations, and overall health.

Precancerous Changes

Loop electrosurgical excision procedure (LEEP)
Cold knife conisation
Laser or ablative therapies

Early-Stage Cervical Cancer

Surgery (fertility-sparing procedures or hysterectomy)
Sometimes combined with radiation

Advanced Cervical Cancer

Radiation therapy
Chemotherapy
Targeted therapy or immunotherapy in selected cases

Prognosis

Very high survival rates when detected early
Prognosis worsens as cancer spreads beyond the cervix
Regular screening is the single most important factor influencing outcomes

With effective screening and vaccination, cervical cancer is considered a potentially eliminable disease.

Prevention

HPV Vaccination

Protects against the most dangerous HPV strains
Recommended for adolescents and available for adults in many countries
Significantly reduces cervical cancer risk at a population level

Regular Screening

Follow age-appropriate screening guidelines
Screening remains necessary even after vaccination

Lifestyle Measures

Avoid smoking
Practice safer sex
Maintain immune health

FAQ

Q: Can cervical cancer develop without HPV?
A: Very rarely. More than 99% of cases are HPV-related.

Q: If I feel well, do I still need screening?
A: Yes. Cervical cancer often causes no symptoms until late stages.

Q: Does HPV vaccination remove the need for Pap smears or HPV tests?
A: No. Vaccines do not cover all cancer-causing HPV types.

Q: Is cervical cancer hereditary?
A: There is no strong inherited genetic pattern, unlike some other cancers.