What is cervical cancer?

Photo courtesy of iStock

South African women have a life-time risk of 1 in 42 of developing cervical cancer, according to the Cancer Association of South Africa. The only cancer more prevalent among SA women is breast cancer. Here’s what you need to know about cervical cancer.

The cervix, also called the neck of the womb, is the lower, narrow part of the uterus (womb). The uterus, a hollow, pear-shaped organ, is located in the pelvis between the bladder and the rectum. The cervix has a canal which is part of the passage connecting the vagina to the uterine cavity and the fallopian tubes.

Like all other organs of the body, the cervix is made up of different tissues. The outer surface of the cervix is covered with an epithelium consisting of a layer of cells like the skin covering the body. The epithelium is constantly replaced by new, young cells forming at the basement membrane (bottom layer) which, while maturing and getting older, move to the surface where they shed and where they can be picked up with a Pap smear.

The body can be exposed to cancer-causing agents that cause the cervical cells to be abnormally shaped. After some time, these cells can form a malignant tumour (cancerous growth). If abnormal cells are found only within the epithelium, the condition is called a pre-cancerous lesion. Once malignant cells penetrate through the basement membrane into the deeper tissue, the condition is called cervical cancer because it may then spread to the rest of the body.

Cervical cancer cells can invade and damage organs near the original tumour, for example, the rectum and/or the bladder. Furthermore, cells from any cancer can break away and enter the lymphatic system or the bloodstream. This is also how cancer of the cervix can spread to other parts of the body, such as nearby lymph nodes, the bones of the spine, and the lungs. The new tumour which forms in a distant organ is called a metastasis and once cancer has spread from its original location, one speaks of a metastatic disease.

When a metastasis develops in another part of the body, the new tumour has the same kind of abnormal cells and the same name as the original (primary) cancer. For example, if cervical cancer spreads to the bones, the cancer cells in the bones are cervical cancer cells. The disease is called a bone metastasis of cervical cancer (it is not bone cancer).

Most cervical cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that form the epithelial surface of the cervix. 

These cells look like flat paving stones. When cancer develops from the endo-cervical canal which is lined with columnar cells, the condition is called adenocarcinoma of the cervix. Squamous cell cancers of the cervix are far more common than adenocarcinomas of the cervix.

(Reviewed by Professor Lynette Denny, Gynaecology Oncology Unit, Department Obstetrics & Gynaecology, University of Cape Town/Groote Schuur Hospital)

Read more:
Symptoms of cervical cancer
Causes of cervical cancer
Risk factors for cervical cancer

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