Types, Tests, and Cancer Prevention

Cervical cancer starts in the cervix, which is the passageway between the vagina and the uterus. Cervical lesions are patches of abnormal cells growing on the cervix.

Sometimes, cervical lesions are made of precancerous cells. Other times, cervical lesions contain cancerous cells.

Thanks to regular screening methods, cervical cancer is not as common as it used to be. The National Cancer Institute estimates that 14,100 people in the United States will be newly diagnosed with cervical cancer in 2022. This will make up about 0.7 percent of all new cancer diagnoses.

Keep reading to learn about the different types of cervical cancer lesions and how they’re diagnosed and treated.

Precancerous cervical lesions happen when cells in the cervix begin to develop abnormal changes. This means they have the potential to develop into cancerous lesions.

Most precancerous cervical lesions go away on their own, without causing any problems. But in some people, these precancerous lesions develop into cancer. Treating precancerous lesions can prevent cervical cancer.

A doctor might use a variety of medical terms when talking about precancerous cervical lesions, including:

• cervical dysplasia
• cervical intraepithelial neoplasia (CIN)
• squamous intraepithelial lesion (SIL)

When examined under a microscope, precancerous cervical lesions are classified into one of three categories. These categories depend on how much of the cervix appears abnormal:

• CIN1 (mild dysplasia): Only a few of the cells appear abnormal. This type will often go away on its own without treatment.
• CIN2 and CIN3 (moderate dysplasia): More of the cells are abnormal. Because this type sometimes goes away on its own, you may choose to get regular screenings instead of treatment after talking with your doctor.
• High grade SIL (severe dysplasia): This is the most serious type. It needs to be treated right away.

Cancerous cervical lesions are classified according to the location of the cancerous cells. These can include cells of the:

• Exocervix: This is the outer part of your cervix that faces down into your vagina. It’s the part that a doctor looks at as a part of a pelvic exam. The cells of the exocervix are called squamous cells.
• Endocervix: This is the inner part of your cervix that faces up toward the uterus. The cells here are called glandular cells.

As such, the main types of cervical cancers are:

• Squamous cell carcinoma: Squamous cell carcinoma begins in the cells of the exocervix, often at the meeting point between the exocervix and endocervix.
• Adenocarcinoma: Adenocarcinoma begins in the glandular cells of the endocervix.
• Adenosquamous carcinoma: Adenosquamous carcinoma affects both squamous and glandular cells in the cervix.

Overall, squamous cell carcinoma is the most common type of cervical cancer. According to the American Cancer Society, it accounts for 9 out of 10 cervical cancers.

The main cause of cervical lesions is an infection with human papillomavirus (HPV). According to the Centers for Disease Control and Prevention (CDC), HPV causes more than 9 out of 10 cervical cancers.

Not all types of HPV can cause cervical cancer. There are about 14 types of HPV that are considered high risk and are responsible for the majority of cancers that are caused by HPV.

HPV infection is very common. Most people contract HPV at some point after becoming sexually active. While the immune system typically clears the infection, sometimes high risk types of HPV can remain and lead to cancer.

The good news is that cervical cancer is now a very preventable cancer because of the HPV vaccine. A 2020 study found that, when given before age 17, the HPV vaccine reduced the risk of cervical cancer by almost 90 percent.

Cervical cancer risk factors

In addition to HPV infection, other risk factors for cervical cancer are:

• having a family history of cervical cancer
• smoking
• having a weakened immune system
• taking birth control pills for a long time
• currently or previously having chlamydia, a sexually transmitted infection (STI)
• factors related to pregnancy, such as being 17 years or younger at the time of your first full-term pregnancy or having three or more full-term pregnancies
• factors related to sexual history, which can raise the risk of contracting HPV, such as:
  • having had many sexual partners
  • becoming sexually active at a younger age
  • having a sexual partner who has a known HPV infection or who has had many sexual partners

Cervical cancer screening is vital in preventing cervical cancer. This can include an HPV test, a Pap test, or both.

The HPV test uses a sample of cervical cells to test for HPV. While it doesn’t specifically detect cervical lesions, it can alert your doctor to the presence of a high risk type of HPV that could lead to precancerous or cancerous changes in the future.

A Pap test also uses a sample of cells collected from the cervix. The cells are examined under a microscope to check for abnormal changes.

The current American Cancer Society cervical cancer screening guidelines are that all people with a cervix between the ages of 25 and 65 get a primary HPV test every 5 years.

If HPV primary testing isn’t available, HPV-Pap co-testing every 5 years, or a Pap test every 3 years, may also be used.

What if my screening result is abnormal?

If the results of your HPV or Pap test come back abnormal, your doctor may do a colposcopy or cervical biopsy. These are two procedures that let them examine the cells of your cervix more closely to check for precancer or cancer.

During a colposcopy, a doctor uses a speculum to open the vagina so they can see the cervix. They then insert a device called a colposcope that has a light and a magnifying glass to help them get a better view of the cervix.

It’s possible that a biopsy may be taken during the colposcopy. In a biopsy, a small sample of cervical cells is removed. The sample is then examined in a lab for signs of precancerous or cancerous cells.

Symptoms of cervical lesions

Precancerous cervical lesions often don’t cause symptoms. Because of this, many people don’t know they have them.

The same can be said about early cancerous lesions. Overall, most people with cervical cancer don’t have symptoms until the cancer has become more advanced. Some of the most common symptoms can include:

• abnormal vaginal bleeding, including:
  • after sex
  • between periods
  • menstrual periods that are much heavier or longer than usual
• after menopause
• vaginal discharge that may contain blood or may smell foul
• pain after sex
• pelvic pain

The fact that precancerous and early cervical cancer lesions don’t typically lead to symptoms makes regular cervical cancer screenings very important for early detection.

For some people, precancerous cervical lesions will go away without treatment. However, if you do have precancerous cervical lesions, getting treatment can go a long way in preventing them from becoming cancerous in the future.

Treatment involves removing the precancerous lesions. This can be accomplished in a few ways.

Ablation-based treatments work by destroying precancerous lesions. This can be done using cold (cryotherapy) or heat (laser surgery).

Excisional treatments remove the precancerous lesions. This can be done with a scalpel that removes a cone-shaped section of tissue (cold knife conization) or by using a thin wire loop containing an electrical current (LEEP).

It takes a long time to develop cervical cancer. According to the World Health Organization (WHO), it can take 15 to 20 years for cervical cancer to develop.

However, the WHO also notes this time frame is different for people with weakened immune systems. This can include people who are:

• living with HIV
• taking immunosuppressive drugs
• organ or bone marrow transplant recipients
• undergoing cancer treatments, like chemotherapy

In people with a weakened immune system, the WHO states cervical cancer can develop in a shorter span of time — about 5 to 10 years.

Precancerous cervical lesions are abnormal changes in cells of the cervix that are not yet cancerous. Some precancerous lesions go away on their own. Others will need to be treated to prevent cancer from developing.

Cervical lesions are mainly caused by HPV infection. Screening tests can detect HPV as well as abnormal changes to cervical cells. An HPV vaccine is available that can greatly reduce the risk of HPV infection and cervical cancer.

It’s not common for precancerous or early cancerous cervical lesions to cause symptoms. This makes regular cervical cancer screenings all the more vital for detecting and treating these lesions early.

Types, Tests, and Cancer Prevention

Cervical cancer starts in the cervix, which is the passageway between the vagina and the uterus. Cervical lesions are patches of abnormal cells growing on the cervix.

Sometimes, cervical lesions are made of precancerous cells. Other times, cervical lesions contain cancerous cells.

Thanks to regular screening methods, cervical cancer is not as common as it used to be. The National Cancer Institute estimates that 14,100 people in the United States will be newly diagnosed with cervical cancer in 2022. This will make up about 0.7 percent of all new cancer diagnoses.

Keep reading to learn about the different types of cervical cancer lesions and how they’re diagnosed and treated.

Precancerous cervical lesions happen when cells in the cervix begin to develop abnormal changes. This means they have the potential to develop into cancerous lesions.

Most precancerous cervical lesions go away on their own, without causing any problems. But in some people, these precancerous lesions develop into cancer. Treating precancerous lesions can prevent cervical cancer.

A doctor might use a variety of medical terms when talking about precancerous cervical lesions, including:

• cervical dysplasia
• cervical intraepithelial neoplasia (CIN)
• squamous intraepithelial lesion (SIL)

When examined under a microscope, precancerous cervical lesions are classified into one of three categories. These categories depend on how much of the cervix appears abnormal:

• CIN1 (mild dysplasia): Only a few of the cells appear abnormal. This type will often go away on its own without treatment.
• CIN2 and CIN3 (moderate dysplasia): More of the cells are abnormal. Because this type sometimes goes away on its own, you may choose to get regular screenings instead of treatment after talking with your doctor.
• High grade SIL (severe dysplasia): This is the most serious type. It needs to be treated right away.

Cancerous cervical lesions are classified according to the location of the cancerous cells. These can include cells of the:

• Exocervix: This is the outer part of your cervix that faces down into your vagina. It’s the part that a doctor looks at as a part of a pelvic exam. The cells of the exocervix are called squamous cells.
• Endocervix: This is the inner part of your cervix that faces up toward the uterus. The cells here are called glandular cells.

As such, the main types of cervical cancers are:

• Squamous cell carcinoma: Squamous cell carcinoma begins in the cells of the exocervix, often at the meeting point between the exocervix and endocervix.
• Adenocarcinoma: Adenocarcinoma begins in the glandular cells of the endocervix.
• Adenosquamous carcinoma: Adenosquamous carcinoma affects both squamous and glandular cells in the cervix.

Overall, squamous cell carcinoma is the most common type of cervical cancer. According to the American Cancer Society, it accounts for 9 out of 10 cervical cancers.

The main cause of cervical lesions is an infection with human papillomavirus (HPV). According to the Centers for Disease Control and Prevention (CDC), HPV causes more than 9 out of 10 cervical cancers.

Not all types of HPV can cause cervical cancer. There are about 14 types of HPV that are considered high risk and are responsible for the majority of cancers that are caused by HPV.

HPV infection is very common. Most people contract HPV at some point after becoming sexually active. While the immune system typically clears the infection, sometimes high risk types of HPV can remain and lead to cancer.

The good news is that cervical cancer is now a very preventable cancer because of the HPV vaccine. A 2020 study found that, when given before age 17, the HPV vaccine reduced the risk of cervical cancer by almost 90 percent.

Cervical cancer risk factors

In addition to HPV infection, other risk factors for cervical cancer are:

• having a family history of cervical cancer
• smoking
• having a weakened immune system
• taking birth control pills for a long time
• currently or previously having chlamydia, a sexually transmitted infection (STI)
• factors related to pregnancy, such as being 17 years or younger at the time of your first full-term pregnancy or having three or more full-term pregnancies
• factors related to sexual history, which can raise the risk of contracting HPV, such as:
  • having had many sexual partners
  • becoming sexually active at a younger age
  • having a sexual partner who has a known HPV infection or who has had many sexual partners

Cervical cancer screening is vital in preventing cervical cancer. This can include an HPV test, a Pap test, or both.

The HPV test uses a sample of cervical cells to test for HPV. While it doesn’t specifically detect cervical lesions, it can alert your doctor to the presence of a high risk type of HPV that could lead to precancerous or cancerous changes in the future.

A Pap test also uses a sample of cells collected from the cervix. The cells are examined under a microscope to check for abnormal changes.

The current American Cancer Society cervical cancer screening guidelines are that all people with a cervix between the ages of 25 and 65 get a primary HPV test every 5 years.

If HPV primary testing isn’t available, HPV-Pap co-testing every 5 years, or a Pap test every 3 years, may also be used.

What if my screening result is abnormal?

If the results of your HPV or Pap test come back abnormal, your doctor may do a colposcopy or cervical biopsy. These are two procedures that let them examine the cells of your cervix more closely to check for precancer or cancer.

During a colposcopy, a doctor uses a speculum to open the vagina so they can see the cervix. They then insert a device called a colposcope that has a light and a magnifying glass to help them get a better view of the cervix.

It’s possible that a biopsy may be taken during the colposcopy. In a biopsy, a small sample of cervical cells is removed. The sample is then examined in a lab for signs of precancerous or cancerous cells.

Symptoms of cervical lesions

Precancerous cervical lesions often don’t cause symptoms. Because of this, many people don’t know they have them.

The same can be said about early cancerous lesions. Overall, most people with cervical cancer don’t have symptoms until the cancer has become more advanced. Some of the most common symptoms can include:

• abnormal vaginal bleeding, including:
  • after sex
  • between periods
  • menstrual periods that are much heavier or longer than usual
• after menopause
• vaginal discharge that may contain blood or may smell foul
• pain after sex
• pelvic pain

The fact that precancerous and early cervical cancer lesions don’t typically lead to symptoms makes regular cervical cancer screenings very important for early detection.

For some people, precancerous cervical lesions will go away without treatment. However, if you do have precancerous cervical lesions, getting treatment can go a long way in preventing them from becoming cancerous in the future.

Treatment involves removing the precancerous lesions. This can be accomplished in a few ways.

Ablation-based treatments work by destroying precancerous lesions. This can be done using cold (cryotherapy) or heat (laser surgery).

Excisional treatments remove the precancerous lesions. This can be done with a scalpel that removes a cone-shaped section of tissue (cold knife conization) or by using a thin wire loop containing an electrical current (LEEP).

It takes a long time to develop cervical cancer. According to the World Health Organization (WHO), it can take 15 to 20 years for cervical cancer to develop.

However, the WHO also notes this time frame is different for people with weakened immune systems. This can include people who are:

• living with HIV
• taking immunosuppressive drugs
• organ or bone marrow transplant recipients
• undergoing cancer treatments, like chemotherapy

In people with a weakened immune system, the WHO states cervical cancer can develop in a shorter span of time — about 5 to 10 years.

Precancerous cervical lesions are abnormal changes in cells of the cervix that are not yet cancerous. Some precancerous lesions go away on their own. Others will need to be treated to prevent cancer from developing.

Cervical lesions are mainly caused by HPV infection. Screening tests can detect HPV as well as abnormal changes to cervical cells. An HPV vaccine is available that can greatly reduce the risk of HPV infection and cervical cancer.

It’s not common for precancerous or early cancerous cervical lesions to cause symptoms. This makes regular cervical cancer screenings all the more vital for detecting and treating these lesions early.

Pathology of the cervix – articles from the specialists of the clinic “Mother and Child”

Pershina Ekaterina Vyacheslavovna

Obstetrician-Gynecologist, Gynecologist-Endocrinologist

Clinical Hospital MD GROUP

The cervix is ​​the “barrier” of the uterus from various infections, it can be said that CMM is the first to be hit. It is important to know that the cervix plays a huge role not only during pregnancy. The pathology of cervix affects the state of the entire reproductive system and can lead to the most serious consequences, the most dangerous of which is the development of a malignant disease (cervical cancer)

Cervical pathology is a concept that describes a number of diseases and conditions in which there is a change in the surface epithelium of the cervix. ⠀

These include: ⠀

1. The background ones, which are characterized by low oncogenic risks, are inflammatory processes, polyps, condylomas, “erosion”, leukoplakia without atypia, cicatricial deformity of the cervix.

2. Precancerous, when the threat of cancer is high, is cervical dysplasia (mild, moderate, severe). In this case, a mild degree can be reversed, without surgical intervention.

3. Cervical cancer.

The main causes (factors) of the pathology of the cervix:

• earlier onset of sexual activity,

• frequent change of partners,

• HPV infection,

• immunodeficiency states,

• smoking,

• infectious diseases of the vagina and cervix (sexual infections),

• abortions and childbirth, leading to a violation of the anatomical integrity of the cervix,

• hormonal imbalance.

Pathology of the cervix, often does not manifest itself in any way and can be a find during a routine examination. But, in the presence of underlying CMM diseases, a change in the nature of menstruation, an increase in the volume of menstrual blood loss, the appearance of pre/postmenstrual discharge, and discomfort during intercourse can be observed.

The appearance of these symptoms is an indication for contacting an obstetrician-gynecologist and screening for cervical pathology, which includes:

• general gynecological examination,

• taking smears (smear for flora, oncocytological examination, PCR for sexual infections, including the determination of HPV),

• colposcopy.

According to the results of the examination, we determine the need for a biopsy of the cervix, curettage of the cervical canal (taking a suspicious fragment of the epithelium of the m/m and endocervix mucosa).

Treatment of cervical disease depends on the cause, type and form of pathology, as well as the stage of development of the disease.

IMPORTANT! As previously mentioned, CMM diseases may not manifest themselves at all, and only in the later stages cause any symptoms. Therefore, it is so important to undergo a basic examination by a gynecologist every year. Even if nothing bothers you!

Directions:

• Operative gynecology,
• Conservative Gynecology,
• Minor gynecological surgeries,
• Cervical biopsy,
• Colposcopy,
• Conservative treatment of cervical pathology,
• Radio wave treatment of cervical pathology,
• Vaginal operations,
• Aesthetic gynecological operations.

Diseases:

• Cervical conization,
• Cervical erosion,
• Surgical treatment of gynecological diseases,
• Gynecological inflammatory diseases.

Make an appointment

to the doctor – Pershina Ekaterina Vyacheslavovna

MD GROUP Clinical Hospital

Major and minor gynecological surgeriesManagement of pregnancyManagement of pregnancy after IVFManagement of pregnancy with Rhesus conflictAge-related gynecology 45+GynecologyColposcopyConservative gynecologyContracts for the management of pregnancySmall gynecological operationsOperative gynecologyUrogynecologyEmergency operations in gynecology

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14.04.2023

Genital herpes
Pershina Ekaterina Vyacheslavovna

causes, symptoms, diagnosis and treatment methods on the Alfa Health Center website

Inflammation of the cervix, or cervicitis, refers to inflammation of the narrow lower part of the organ. A healthy uterus is normally covered with epithelium that produces a mucous secretion. This substance plays a protective role and prevents the penetration of infections into the internal cavity. In violation of the secretory function of cells, an active growth of pathogenic microflora occurs, symptoms of inflammation of the cervix develop.

According to statistics, cervicitis is diagnosed in 30% of women of childbearing age. Pathology can be in the cervical canal, then they talk about endocervicitis, or in the vaginal part of the cervix – exocervicitis. The peak incidence is recorded in the age group of 17-28 years, when a woman shows maximum sexual activity and rarely uses barrier contraceptives.

Treatment of inflammation of the cervix in the initial stage is carried out by conservative methods and does not require radical measures. The prognosis is favorable. But for this, a woman should regularly undergo medical examinations and consult a gynecologist when the first symptoms of the disease appear.

You can undergo an examination with signs of cervicitis in Moscow at the Alfa Health Center clinic.

Signs of inflammation of the cervix

Complaints of patients are different in acute and chronic cervicitis.

The main symptoms of inflammation in the cervix:

• discharge from the genital organs of a purulent or mucous type;
• pain, heaviness in the uterus;
• discomfort, burning in the urinary tract, aggravated by sex, urination;
• a slight rise in temperature to 37-37.2ºС.

In some cases, the inflammatory process proceeds without pronounced clinical signs and is determined by the results of a gynecological smear.

Causes of cervicitis

Inflammation of the cervix and appendages can be caused by the following factors:

• sexually transmitted disease: gonorrhea, trichomoniasis, chlamydia and other infections;
• microorganisms that are normally present on the vaginal mucosa;
• mechanical injuries during gynecological operations, conization, childbirth, from the use of the uterine ring, treatment with iodine, dimexide, and other means;
• hormonal disorders;
• antibiotic treatment, chemotherapy courses;
• Allergy to latex or substances used to treat condoms
• diseases of the female genitourinary system: colpitis, endometritis, cystitis, erosion and others.

A common cause of inflammation of the cervix is ​​an independent, uncontrolled intake of antibiotics. Medicines inhibit the beneficial microflora of the vagina, reduce local immunity. Organisms resistant to antibiotics appear in the woman’s biota. These are the most difficult cases of mixed infections that require an individual treatment plan.

There are also such risk factors as young age, frequent change of sexual partners.

Types of cervicitis due to inflammation

• Purulent. Occurs when infected with a sexually transmitted disease. For purulent cervicitis, mucous discharge with an unpleasant odor is characteristic, involvement of nearby organs and tissues in the process.
• Viral. The mucous membrane becomes inflamed when infected with cytomegalovirus, human papillomavirus or other pathogens. The disease may be accompanied by itching, the appearance of polyps.
• Bacterial. Cervicitis develops from vaginosis, when there is an active reproduction of pathogens of the natural microflora of the vagina. Possible infection from a sexual partner.
• atrophic. The cause of the disease is the thinning of the mucous membranes. Atrophic cervicitis is often found in women during menopause.

Cervicitis diagnostics

The first stage is an examination by a gynecologist and a colposcopy. Reddened, swollen mucous membranes, discharge clearly indicate a pathology. To clarify the diagnosis, a vaginal smear, a PCR test, and a biopsy of the affected tissue are performed. Ultrasounds, blood and urine tests may also be required. The doctor prescribes the studies necessary for the differential diagnosis of inflammation with dysplasia (precancerous condition), erosion and other diseases.

Treatment of cervicitis

To select an adequate treatment regimen for cervical disease, the duration, severity of the disease, and the cause are taken into account. With the infectious nature of cervicitis, therapy will also be required for the sexual partner.

To treat acute inflammation of the cervix, the doctor may prescribe:

• Antibiotics of the fluoroquinolone or macrolide group. At the same time, it is recommended to take antimycotic drugs that will prevent the development of candidiasis;
• Means for restoration of microflora. A woman is prescribed therapeutic suppositories, gels with lactobacilli;
• Immunomodulators. Preparations strengthen local immunity, help beneficial microflora to resist the effects of antibiotics. Immunomodulators are taken in the form of powders or tablets;
• Hormonal drugs with estrogens for the regeneration of the thinned mucous layer;
• Physiotherapy: endocervical electrophoresis, magnetotherapy, irradiation of the cervix with ultraviolet, laser, microwaves, low-frequency ultrasound. Treatment is primarily aimed at restoring blood and lymph microcirculation in the affected tissues. In chronic inflammation of the cervix, physiotherapy is carried out in courses several times a year to prevent exacerbation.

In rare cases, surgery is indicated. As a rule, the operation is performed with severe and extensive inflammation, when the woman did not seek diagnosis at the onset of the disease. For treatment, the method of cryodestruction, diathermocoagulation or chemical coagulation of pathological areas is used.

Particular attention is paid to the treatment of exacerbation of cervicitis in pregnant women. The doctor carefully selects drugs and calculates the dosage in order to eliminate risks to the fetus.

What is dangerous inflammation of the cervix

Self-medication is risky with complications, so only a doctor should decide how to treat a woman. If the patient does not seek help in a timely manner, acute cervicitis becomes chronic. A woman is threatened with such consequences as erosion, miscarriage, the spread of the inflammatory process to the appendages. The risk of developing cancer increases. Chronic cervicitis leads to the formation of adhesions and infertility. Patients often experience chronic pelvic pain, menstrual irregularities, and other symptoms that reduce quality of life.

Inflammation of the cervix during pregnancy

Cervicitis occurs in two out of three pregnant women at different gestation periods. The disease is acute, not only the wall of the vagina becomes inflamed, but also the labia. Women complain of burning, itching in the perineum, discomfort. Inflammation of the cervix during pregnancy is one of the factors of miscarriage, so you need to see a doctor as soon as possible.

Cervicitis in this case is chronic. A woman may not be aware of inflammation until pregnancy, when the pathology manifests itself against the background of natural immunodeficiency.

Doctor’s recommendation

Every year more and more women come to us for the treatment of chronic inflammation of the cervix. The reason is that the patient simply does not notice or ignores the first signs of cervicitis. Often we identify inflammation when dealing with completely different complaints. This is dangerous for future motherhood. We recommend that couples with a history of stillbirth, miscarriage, intrauterine infection of the fetus undergo a thorough examination to identify hidden infectious agents.