Despite the presence of well-organized cervical screening programmes in the UK and the introduction of HPV vaccination in 2008 for schoolgirls, the incidence of cervical cancer is not expected to significantly decrease over the next few years (1)
- over the last decade, cervical cancer incidence rates have increased by around 4% in females in the UK, although higher rates have been witnessed in Northern Ireland. Incidence rates for cervical cancer are projected to rise by 43% in the UK between 2014 and 2035, to 17 cases per 100,000 females by 2035
Cancer of the cervix often has no symptoms in its early stages and may be detected after an abnormal screening smear test
- symptoms can be subtle and attributed to benign gynaecological conditions or remain asymptomatic until the cancer has reached an advanced stage
- when symptomatic, the most common symptoms are abnormal vaginal bleeding, intermenstrual (IMB), postcoital (PCB) or postmenopausal bleeding (PMB)
- other symptoms of cervical cancer may include dyspareunia and abnormal vaginal discharge. Abnormal appearance of the cervix during examination should also raise suspicion and referral for further investigations (1)
- it is possible for women of all ages to develop cervical cancer, but traditionally the condition mainly affected sexually active women aged between 30 and 45 years of age, however, data from Cancer Research UK shows the peak age of incidence has reduced to 25-29 years of age
- cervical cancer is very rare in women under 25 years old and may be more difficult to prevent in younger age women (1)
- extra cervical advanced stage disease with spread into surrounding tissue and organs, it can cause other symptoms, including haematuria, urinary incontinence, bone pain, lower limb oedema, flank or loin pain (due to hydroureter or hydronephrosis), changes to bladder and bowel habits, loss of appetite, weight loss and fatigue (2)
Prognosis correlates with stage, histological diagnosis, socio-economic status and age at presentation.
- More than 80% of women survive for one year or more.
- More than 65% of women survive for five years or more.
- Almost 65% of women survive for 10 years or more. (3)
- Most recurrence happens within 2 to 3 years. (4)
References:
- British Gynaecological Cancer Society (BGCS) Cervical Cancer Guidelines: Recommendations for Practice (Accessed 21/10/2020).
- Fowler J et al. Cervical Cancer. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.2023 Nov 12.
- National Cancer Institute: Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: cervical cancer. 2023 [internet publication].
- Elit L, Fyles AW, Oliver TK, et al. Follow-up for women after treatment for cervical cancer. Curr Oncol. 2010 Jun;17(3):65-9.