After breast cancer, cancer of the cervix follows with colon cancer as the second most common cancers among women worldwide. Cervical cancer is characterized by malignant cells found in the tissues of the passage that connects the uterus to the vagina, which is called the cervix. Cancer that has penetrated beneath the surface of the cervix is called invasive.
The United States alone will see 12,800 new cases of invasive cervical cancer diagnosed in 2000. Worldwide, this number reaches 400,000, with the highest number of victims being in the economically disadvantaged populations of both developing and industrialized countries. Noninvasive cancer is four times more common than invasive cancer. In 2000, about 4,600 U.S. women are expected to die from cervical cancer.
Cervical cancer generally has a slow and gradual onset. During the pre-cancerous stage, called dysplasia, tissues in the cervix begin to change. Abnormal cells found in these changing tissues can usually be detected with a Pap smear. In a Pap smear, cells are collected from the cervix and then examined in a laboratory. If left undetected and allowed to grow, the abnormal cells may develop into cancer cells and invade into the cervix or spread to surrounding tissues.
The extent of tumor growth and how far the cancer cells have penetrated into neighboring tissues and organs determines the stage of the cancer when it is diagnosed. Prognosis for patients improves dramatically the earlier the disease is detected. The stage of cervical cancer diagnosed is the most important factor for deciding the course of treatment for the disease. The five-year survival rate for early invasive cervical cancer is 91 percent. For pre-invasive cervical cancer, the rate is nearly 100 percent. For all stages of the disease combined, five-year survival is 69 percent.
Usually, there are few if any symptoms during the early stages of cervical cancer. Therefore, regular gynecologic examinations with Pap smears are the best way to detect the disease and thus prevent deaths from cervical cancer. During the last 50 years in the United States, screening programs based on regular Pap smears and pelvic examinations have led to a marked decline in incidence of cervical cancer and in deaths from the disease. From 1955 to 1992, the number of cervical cancer deaths in the United States declined by 74 percent, according to the American Cancer Society (ACS). The ACS credits the increased use of Pap smears as the main reason for the change.
Though considered the most effective screening tool for cervical cancer, the Pap test is not 100-percent accurate. This has led to research efforts to reduce the Pap test's false-negative rate by improving sample collection and test analysis methods and developing new screening technologies. Other research efforts currently underway are aimed at preventing cervical cancer through studying its mechanisms of development and the association with risk factors and other factors that can increase a person's vulnerability to the disease.
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