What is cervical cancer?

Qu'est-ce que le cancer du col de l'utérus ?

What is cervical cancer?

Cervical cancer is the development of a malignant tumor that starts in the lining of the cervix, the narrow part of the body that separates the vagina from the uterus. This cancer is caused by a sexually transmitted infection linked to prolonged contact with a virus of the human papillomavirus family (notably HPV 16 and 18). This infection is the most common STI in the world as 80% of women are infected at least once in their lives. But in theory, HPV is eliminated naturally, however, the infection can persist and develop into precancerous lesions and then into cancer if it is not detected and treated in time.

This is why it is very important to have regular check-ups, from the age of 25 and even after the age of 50. They allow to detect precancerous lesions and to treat them before they develop into cancer. Cervical cancer is one of the most frequently diagnosed cancers, even though it is often symptomless, which in most cases makes it possible to treat it in time because this cancer evolves slowly. In fact, on average, about ten years pass between the moment of contact with the papillomavirus and the moment when the first precancerous lesions develop, and another ten years before the lesions develop into cancer.

Finally, the transmission of the virus is done by contact with the skin and the mucous membranes, in particular during sexual intercourse, with or without penetration. This is why condoms are often not sufficient because they do not provide complete protection since the base of the penis is often not covered.

Two types of cancer:

Almost all cervical cancers (80-90%) start in the lower part of the cervix, in the ectocervix. This cancer is called squamous cell carcinoma.

The remaining 10 to 20% of cancers start in the upper part of the cervix, in the endocervix. This cancer is called adenocarcinoma.

Other risk factors:

Although HPV infection remains the primary cause of cervical cancer development, there are factors that still increase the risk of getting the virus or failing to clear it:

  • Having many partners, as with any STI, multiplies the risk of infection by the most virulent HPV viruses despite the use of a condom

  • Smoking (even passive)

  • Long-term use of hormonal contraception

  • Presence of other STIs (especially chlamydia and genital herpes)

  • A weakened immune system (medical treatment or HIV)

  • Having had multiple children (multiparity)

Signs to be aware of:

HPV infection usually has few or no symptoms. Nevertheless, in case of bleeding after sexual intercourse or generally outside the periods, pain during sexual intercourse, pain in the pelvic area, we advise you to consult a specialized doctor.

Treatment:

If it turns out to be cervical cancer, several solutions may be offered.

First, a study of the extent of the cancer will be performed to establish a protocol for treating the cancer. The size, depth and possible extension of the tumor will be taken into account. Although cervical cancer is often diagnosed at stage 1, i.e. the cancer is located in the cervix, it can also spread to neighboring areas and then further afield as time goes on.

Treatment of cervical cancer often involves surgery (removal of the upper layers of the cervix or removal of the cervix in less advanced cases, removal of the cervix, uterus, fallopian tubes, upper vagina and ovaries in more advanced cases) combined with radiation therapy (internal or external). Then chemotherapy may be considered in some cases (if the tumor is larger than 4cm or if it has spread to different areas). The goal in all cases is to try to reduce the size of the tumor and/or block the multiplication and migration of the cancer cells.

A vaccine?

There is a vaccine against human papillomavirus, which must be repeated a few times and which is recommended before any sexual activity. Nevertheless, the vaccine does not protect against all HPV infections, which are numerous. We can therefore only advise you, as explained previously, to carry out regular smears.

The papillomaviruses in figures:

  • The cancer of the uterine cervix touches each year more than 3 000 women in France and 500 000 in the world

  • More than 1,100 women die of cervical cancer each year

  • ¾ of women are under 65 years of age at the time of diagnosis of cervical cancer

But HPV also causes each year :

  • 500 vulvar cancers

  • 300 vaginal cancers

  • 1 100 cancers of the anus

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