Cervical cancer

Cervical cancer is the growth of abnormal cells in the lining of the cervix, but it can spread to tissues around the cervix such as the vagina, or to other parts of the body such as the lungs or liver.

Cervical cancer was the 15th most commonly diagnosed cancer among females in Australia in 2012.

It is expected that the incidence rate of cervical cancer is highest if you are over 85, followed by age groups 75 to 79 and 35 to 39.

Symptoms

Early changes in cervical cells rarely cause symptoms. If early cell changes develop into cervical cancer, the most common signs include:

• vaginal bleeding between periods
• menstrual bleeding that is longer or heavier than usual
• bleeding after intercourse
• pain during intercourse
• unusual vaginal discharge
• vaginal bleeding after menopause
• excessive tiredness
• leg pain or swelling
• lower back pain.

Early detection test

The National Cervical Screening Program recommends all women between 18 and 70 who have ever been sexually active have regular Pap tests.

Women should start having Pap tests every two years from 18 to 20 years of age, or one to two years after sexual activity starts - whichever is later.

For more information go to the cervical screening page.

Prevention

Vaccinating against Human Papillomavirus (HPV) provides highly effective protection against the development of HPV-related cancers and disease caused by HPV types 6, 11, 16 and 18.

The best time to be vaccinated is before a person becomes sexually active. If a person has had sexual contact then they may have been infected with some of these HPV types.

You should not have the HPV vaccine if you have had a serious allergic reaction (anaphylaxis) to a previous HPV vaccine, yeast or any other vaccine components. You should also not have the vaccine if you are pregnant.

Regular Pap tests are still important because the HPV vaccine doesn't protect against all cervical cancers.

Diagnostic test

The usual tests to diagnose cervical cancer are:

• colposcopy
• biopsy, cone biopsy or large loop excision of the transformation zone.

More tests are needed for staging the cancer including:

• blood tests
• examination under anaesthetic - cystoscopy and proctosignmoidoscopy
• chest x-ray
• CT scan
• MRI
• PET scan.

Deciding on your treatment

Your gynaecologist or surgeon will first discuss your treatment with other specialists and then discuss your treatment options with you.

If you live in the Top End

Your case will be discussed with other specialist doctors at the Royal Darwin Hospital.

If you live in Central Australia

The gynaecologists or local surgeon will assess your case and refer you to the specialists in Darwin or interstate if appropriate.

Treatment

For very early and non-bulky disease the treatment is surgery, sometimes with chemo-radiotherapy afterwards. 

If the tumour is small, a cone biopsy may be done. In some cases hysterectomy (surgical removal of the uterus) is needed.

For locally advanced disease a combination of radiotherapy and chemotherapy is used.

For metastatic disease, the treatment is chemotherapy or palliative care alone.