In the early stages of cervical cancer most women are asymptomatic until the cancer becomes invasive. When symptoms are present they can include light vaginal bleeding or spots of blood outside of normal menstruation, unusual vaginal discharge, pain or vaginal bleeding with sexual intercourse, and post-menopausal vaginal bleeding. Once the cancer has invaded the tissue surrounding the cervix, a woman may experience pain in the pelvic region as well as heavy bleeding from the vagina. In advanced disease, metastases may spread the cancer to the abdomen, lungs or elsewhere. In advanced cervical cancer, symptoms may include fatigue, loss of appetite, weight loss, pelvic and back pain, painful and swollen legs, heavy bleeding from the vagina, and bone discomfort and fractures.
Causes and Risk Factors
Nearly all cases of cervical cancer are caused by infection with oncogenic (high-risk) types of human papillomavirus, (HPV). Infection with HPV is estimated to be the cause of approximately 90% of all cervical cancers. There are about 12 high-risk HPV types that produce a protein that can cause cervical epithelial cells to grow uncontrollably. These viruses may also produce another protein that interferes with tumor suppression by the immune system. In addition, infections with these viruses may also cause anal cancers as well as many vaginal, vulvar and penile cancers. Some cases of oropharyngeal cancers may also be caused by HPV.
Risk factors for cervical cancer include the following:
- Weakened immune system due to HIV infection, AIDS, or other condition that causes immunosuppression
- Multiple pregnancies (three or more)
- Long-term oral contraceptive use
- Multiple sexual partners