Cervical cancer begins in the cervix, the lower, cylinder-shaped part of the uterus. Its upper margin is connected to the uterus, while its lower margin is connected to the vagina.
Approximately 700 women are diagnosed with cervical cancer every year in Australia. Of those, 200 will die of their disease. Cervical cancer develops on the basis of an infection with one or more strains of HPV (Human Papilloma Virus) through early age at intercourse, multiple sexual partners and smoking. Cervical cancer develops through pre-cancerous stages (cervical dysplasia, CIN) over many years. The introduction of the PAP smear screening has reduced the incidence of cervical cancer dramatically in countries of the developed world. While the incidence of cervical cancer in USA, Australia and Europe is low, its incidence in countries of the developing world is very high.
Australia was one of the first countries to roll out a national cervical cancer immunisation campaign using Gardasil. Gardasil is a vaccine that protects young women from the strains of human papillomavirus (HPV) that cause 70% of cervical cancers. Vaccination with Gardasil is most effective when given to females before they are likely to be exposed to HPV. Four out of five people will be exposed to HPV during their lifetime and exposure to HPV from a single lifetime partner can still be enough to result in an infection that can lead to cervical cancer.
Treatment depends on the stage of disease. Very early cervical cancer (microinvasive) can be treated by a cone biopsy or a ‘simple’ hysterectomy. Patients with cervical cancer limited to the uterine cervix require a radical hysterectomy, at which a safety margin around the cancer is taken. These patients also require removal of lymph nodes along the large blood vessels in the pelvis. Patients with advanced disease (stage 2+) require a combination of chemotherapy (weekly) plus radiotherapy (daily) for four to six weeks. Survival depends on the stage of disease with more than 75% of patients surviving stage 1.