Oncology

Cervical cancer – what you should know

Cervical cancer is a rather rare disease in Switzerland. It can be cured if diagnosed at an early stage and managed effectively. Most cases of cervical cancer can be prevented by HPV vaccination and other preventive measures like screening for, and treating precancerous lesions. Learn more here.

31 March 2022

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In Switzerland, around 250 women are diagnosed with cervical cancer annually, around 70 die of it every year. The rate of new cases increases between the ages of 25 and 44. This makes cervical cancer the thirteenth most common cancer in women in Switzerland. In 2020, more than 600,000 women were diagnosed with cervical cancer worldwide and more than 340,000 women died from the disease.

Origin and forms of Cervical Cancer

Cervical cancer develops in almost all cases from the surface cells on the cervix or from the glandular cells of the cervix. In technical language, cervical cancer is therefore called “cervical carcinoma” (Latin cervix = neck).

The cervix is made of two parts and is covered with two different types of cells.

  • The endozervix is the opening of the cervix that leads into the uterus. It is covered with glandular cells.

  • The exozervix (or ectocervix) is the outer part of the cervix that can be seen by the doctor during an exam. It is covered in squamous cells.

The place where these two cell types meet in the cervix is called the transformation zone. The exact location of the transformation zone changes as you get older and if you give birth. Most cervical cancers begin in the cells in the transformation zone.

Pre-cancers of the cervix

The normal cells of the cervix first gradually develop abnormal changes that are called “pre-cancerous”. It is possible that a precancerous stage will develop into cervical cancer. It is therefore important to have precancerous lesions checked regularly and treated if necessary.

Types of cervical cancer

Cervical cancers and cervical pre-cancers are classified by how they look in the lab s with a microscope. The main types of cervical cancers are squamous cell carcinoma and adenocarcinoma.

  • Squamous cell carcinomas develop from cells in the exocervix and most often begin in the transformation zone.
  • Adenocarcinomas develop from the mucus-producing gland cells of the endocervix.

Less commonly, there are adenosquamous carcinomas or mixed carcinomas that have features of both types.

Symptoms of cervical cancer

Precancerous lesions of the cervix usually do not cause any symptoms. Symptoms often appear only in advanced stages. These may include the following:

  • Unusual vaginal bleeding (bleeding after intercourse, bleeding after menopause, bleeding between periods).
  • Bad-smelling discharge from the vagina
  • pain in the lower abdomen
  • unexplained weight loss

The above-mentioned complaints may also have other causes. Nevertheless, if one or more symptoms are present, a doctor should be consulted.

Risk factors

The most important risk factor for cervical cancer is infection with human papillomavirus (HPV). This accounts for around 99% of all cases. HPV are extremely common and are transmitted through sexual contact.

Other possible risk factors include:

  • sexual activity at a young age
  • many sexual partners
  • a partner who is considered a high-risk partner (someone with HPV infection or with many sexual partners)
  • smoking
  • weakened immune system
  • long-term use of the contraceptive pill

Prevention through vaccination

Teenagers and young adults can protect themselves against the most dangerous types of HPV vaccine.

The vaccination is intended to reduce the risk of contracting dangerous HPV. In Switzerland, HPV vaccination is free of charge for all adolescents and young adults between the ages of 11 and 26 as part of cantonal vaccination programs.

Early detection

The best way for early detection is regular screening by the gynecologist through Pap test (taking cells from the cervix, which are examined in the laboratory for cancer and precancerous lesions) and/or HPV test (looking in cervical cells for parts of the DNA of HP viruses that are most likely to cause cervical cancer).

Treatment

Cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively. Treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy and best supportive care.

CH-NON-00150, 12/2021