Cervical cancer

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Cervical cancer occurs when the cells in the cervix begin to grow and replicate in an abnormal and uncontrolled way. When this happens, the body cannot organize these cells for normal function and the cells form a mass that is called a tumour. Malignant tumours in the cervix can spread to other parts of the body, crowding and destroying normal cells.

Cervical cancer often grows very slowly over a period of years. Before the cancer actually develops, there are early changes that occur in the cells of the cervix. While these abnormal cells (called cervical intra-epithelial neoplasia or CIN) are not in and of themselves cancerous, and many women with these cells do not develop cancer, these cells may lead to cancer. These cells are sometimes referred to as precancerous, meaning that they have the potential to develop into cancer if not treated.

CIN usually results from a viral infection by the human papillomavirus (HPV). HPV is a common virus that is generally sexually transmitted. While there are dozens of HPV type viruses, only a few have been linked to the development of cervical cancer. Even when women have the virus, their immune system generally eliminates it. For women whose immune system does not eliminate the virus, HPV may in time develop into cervical cancer.

All women are potentially at risk of developing cervical cancer at some point in their lifetime. The most common risk factors for cervical cancer include an early age of first intercourse, having multiple sexual partners, and having experienced a weakened immune system. Cervical cancer is most often diagnosed in women in their late 30s. It can, however, be diagnosed in younger as well as older women.

The most common symptoms of cervical cancer include abnormal bleeding, such as between periods or after intercourse. Sometines, there is also a vaginal discharge, and discomfort during intercourse. Women who have had their menopause may experience new bleeding. While these symptoms can be caused by conditions other than cervical cancer, they should raise your doctor's suspicion that you may have cervical cancer.

Cancer of the cervix is the commonest cancer and the leading cause of cancer mortality among women in developing countries. According to WHO, in 2008, there were more than 530 000 new cases of cervical cancer worldwide and 275,000 deaths from cervical cancers. Over 90% of them were recorded in developing countries. In the WHO African region, 75,000 new cases were recorded in the same year and 50,000 women died of the disease.

High incidences of cervical cancer are reported in Africa at rates exceeding 50 per 100,000 populations and age-standardized mortality sometimes exceeding 40 per 100,000 populations. For example, between 1981 and 1990, data from Nairobi hospital records showed that cervical cancer accounted for 70%–80% of all cancers of the genital tract and 8%–20% of all cancers. Cervical cancer remains a major public health problem in developing countries, especially in Africa where an estimated 53,000 women die of the disease every year. Fortunately, we now have measures that offer unprecedented opportunities for preventing this cancer that devastates families: efficient, low-cost screening approaches suitable for low-resource areas and vaccines that are efficacious in preventing the infections and precancerous changes that can lead to cervical cancer.