INTRODUCTION
- Cervical cancer is a growth of cells that starts in the cervix. The cervix is the lower part of the uterus that connects to the vagina.

Types of cervical cancer
Cervical cancer is divided into types based on the type of cell in which the cancer begins. The main types of cervical cancer are:
- Squamous cell carcinoma. This type of cervical cancer begins in thin, flat cells, called squamous cells. The squamous cells line the outer part of the cervix. Most cervical cancers are squamous cell carcinomas.
- Adenocarcinoma. This type of cervical cancer begins in the column-shaped gland cells that line the cervical canal.
Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix.
EPIDEMIOLOGY
Cervical cancer ranks 4th for both incidence and mortality worldwide, after breast, colorectal, and lung cancers. In Kenya it is the leading cause of death. Global estimates for the year 2020 were 604,127 new cases and 341,831 deaths 85% of cancers occur in developing countries. Kenyan estimates for 2022 were 5000 new cases and 2500 deaths
CAUSES
- Persistent infection with hrHPV
- Transmitted through sexual intercourse
- Approx. 95% clear the virus from their bodies
- There are approximately 14 hrHPV types associated with ca cervix
- These are responsible for about 99% of all cervical cancers worldwide
- HPV-types 16 and 18 are the most commonly involved (70%)
Risk factors
Risk factors for cervical cancer include:
- Early sexual activity. Having sex at an early age increases your risk of HPV.
- Increasing number of sexual partners. The greater your number of sexual partners, and the greater your partner’s number of sexual partners, the greater your chance of getting HPV.
- Other sexually transmitted infections. Having other sexually transmitted infections, also called STIs, increases the risk of HPV, which can lead to cervical cancer. Other STIs that increase the risk include herpes, chlamydia, gonorrhea, syphilis and HIV/AIDS.
- A weakened immune system. You may be more likely to develop cervical cancer if your immune system is weakened by another health condition and you have HPV.
- Exposure to miscarriage prevention medicine. If your parent took a medicine called diethylstilbestrol, also known as DES, while pregnant, your risk of cervical cancer might be increased. This medicine was used in the 1950s to prevent miscarriage. It’s linked to a type of cervical cancer called clear cell adenocarcinoma.
- Smoking tobacco. Smoking increases the risk of cervical cancer. When HPV infections happen in people who smoke, the infections tend to last longer and are less likely to go away. HPV causes most cervical cancers.
PREVENTION






Prevention
To reduce your risk of cervical cancer:
- Ask your doctor about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of cervical cancer and other HPV-related cancers. Ask your health care team if an HPV vaccine is right for you.
- HPV vaccines for girls aged 10-14 years
- HPV vaccines Can be given up- to 25 years of age
- A newer version 9 valent can be given up to 45 years
- WHO recommends a one/two dose schedule/ within a 6-month period?
2. Have routine Pap tests. Pap tests can detect precancerous conditions of the cervix. These conditions can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest beginning routine Pap tests at age 21 and repeating them every few years.
- Pap smears pick up on abnormal cervical changes that, in some cases, may suggest that cancer is likely to develop or that cancer has already developed.
- Women ages 21-29– every 3 years should do pap smear.
- Women ages 30-65 every 3 years/ every 5years if co-test pap smear.
- Women over age 65 can stop having Pap smears if they have either 3 negative Pap tests in a row or 2 negative co-test results in a row within the past 10 years.
- Testing is more frequent if you are immunosuppressed
3. Practice safe sex. Reduce your risk of cervical cancer by taking measures to prevent sexually transmitted infections. This may include using a condom every time you have sex and limiting the number of sexual partners you have.
4. Don’t smoke. If you don’t smoke, don’t start. If you do smoke, talk to a health care professional about ways to help you quit.


SIGNS AND SYMPTOMS
- Vaginal bleeding after intercourse, between periods or after menopause.
- Menstrual bleeding that is heavier and lasts longer than usual.
- Watery, bloody vaginal discharge that may be heavy and have a foul odor.
- Pelvic pain or pain during intercourse.
DIAGNOSIS
- A biopsy from the cervix is taken for evaluation
- This is the confirmatory test
- At the time the biopsy is taken – staging is done to estimate the spread of the disease
Other supporting investigations
- CHEST X-RAY
- MRI
- BLOOD TESTS

FIVE YEAR SURVIVAL RATES FOR CERVICAL CANCER
- Stage I 80%
- Stage II 65%
- Stage III 30%
- Stage IV 15%
When to see a doctor
Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.
Preparing for your appointment
Make an appointment with a doctor or other health care professional if you have symptoms that worry you. If a health professional thinks you might have cervical cancer, you may be referred to a doctor who specializes in treating cancers that affect the female reproductive system, called a gynecologic oncologist.
Here’s some information to help you get ready for your appointment and what to expect from your health care team.
What you can do
- Be aware of any pre-appointment restrictions, such as not eating solid food on the day before your appointment.
- Write down your symptoms, including any that seem to not be related to the reason why you scheduled the appointment.
- Write down your key medical information, including other conditions.
- Write down key personal information, including anything that increases your risk of STIs, such as early sexual activity, multiple partners or unprotected sex.
- Make a list of all your medicines, vitamins or supplements.
- Ask a relative or friend to come with you, to help you remember what your health care team says.
- Write down questions to ask your team.
Questions to ask your doctor
- What’s the most likely cause of my symptoms?
- What kinds of tests do I need?
- What treatments are available, and what side effects can I expect?
- What is the prognosis?
- How often will I need follow-up visits after I finish treatment?
In addition to the questions that you’ve prepared, don’t hesitate to ask other questions that occur to you.
What to expect from your doctor
Be prepared to answer some questions about your symptoms and your health history, such as:
- What symptoms are you experiencing? How severe are they?
- When did you first begin experiencing symptoms? Have they changed over time?
- Have you had regular Pap tests since you became sexually active? Have you ever had irregular Pap test results in the past?
- Have you ever been treated for a cervical condition?
- Have you ever been diagnosed with an STI?
- Have you ever taken medications that suppress your immune system?
- Do you or have you ever smoked? How much?
- Do you want to have children in the future?
Together, we can end cervical cancer! 💪 Let’s raise awareness, support one another, and prioritize screening and vaccination. Stand with us in the fight against cervical cancer.
#EndCervicalCancer #HealthMatters #TogetherWeCan #Tmgfoundation