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Cervical Cancer: Who's At Risk?

Seventy thousand woman are diagnosed with cervical cancer in its earliest stage each year. It's vital to catch the disease before it spreads. CBS This Morning's Health Contributor Dr. Bernadine Healy has more on the risk factors and treatment.



Who is at risk?

Unlike most other cancers, cervical cancer hits women when they're young.

The earliest and more easily treated form of cervical cancer tends to show up when a woman is in her mid-to-late thirties, and the more advanced forms in her mid-forties.

Risk Factors

  • The major risk factor for this cancer is an active sex life. What that means is having multiple sex partners, having a first sexual encounter before age 18, having had more than five pregnancies, and having a history of virtually any sexually transmitted disease from herpes to HPV, the human papilloma virus.
  • Another risk factor is smoking. It increases your chance of getting cervical cancer fourfold, no matter how safe the sex you practice.

Is cervical cancer easily detected?

Most of the time cervical cancer is picked up through a pap smear before a woman experiences its symptoms of abnormal vaginal bleeding or bleeding after sexual intercourse.

To get the pap smear, the physician uses a small spatula to scrape off cervical cells, which are then smeared on a glass slide, processed and looked at under a microscope. If the cells in the pap smear suggest cancer, the next diagnostic step is a closer examination of the lining of the vagina and cervix with a special magnifying instrument called a colposcope, and a biopsy.

How is it treated?

Seventy thousand woman a year are diagnosed with cervical cancer in its earliest stage. At that point it is microscopic, involving only the cells lining the cervix, and is highly curable. The abnormal tissue is removed in a simple outpatient operation using local anesthesia. The cervix and uterus stay intact, so there is no concern about affecting a woman's ability to have children after the procedure. And as long as the diagnosis was accurate, the recovery rate is 100 percent.

When the cancer has spread out of its original site but is still present only in the cervix, a total hysterectomy is necessary, but the chance of a complete cure is excellent, in the range of 90-98 percent.

The New England Journal of Medicine looked at the treatment of invasive cervical cancer - that is, when the cancer has spread beyond the cervix. A total 14,000 women are diagnosed with invasive cervical cancer every year in the United States, and nearly 5,000 die from it. Treatments for it have not advanced since the 1950s.

Radiation has been the standard treatment after surgery to remove the tumors. But now, three separate studies point to a major advancement combining two modes of therapy. Researchers found that the risk of death fell by as much as 50 percent when chemotherapy - particularly he drug cisplatin combined in some cases with fluorouracil - was added to radiation therapy.

How can a woman reduce the risk?

  • If we think back to the risk factors, protection is key. If you aren't absolutely sure about your partner's sexual history, use a condom. Knowing your partner is AIDS free isn't enough to save your life. All types of sexually transmitted diseases put you at risk.
  • Stop smoking.
  • Any woman who is sexually active or over the age of 18 should see her gynecologist yearly and have a pap smear. Catch this cancer early. It makes all the difference to your quality of life, your ability to have children, your happiness and your survival.

For more information, see the New England Journal of Medicine

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