Cervical Cancer

The cervix is the lowest part of the uterus (“womb”), and forms the junction between the vagina and uterus in cis-women and some trans-men. The main functions of the cervix include forming the pathway for passage of sperm into the uterus for fertilization, keeping bacteria and other infectious agents out, contraception, and childbirth.  

The cervix is made up of muscular tissue, blood and lymph vessels. Cancer arises when cells lining the cervix change from normal to abnormal, and grow out of control. The most common form of cervical cancer is called “squamous cell carcinoma”, which is almost always associated with human papilloma virus (HPV).  

Importance for PHIV50+

Cervical cancer affects cis-women and trans-men who still have a cervix. It is more common in those over the age of 45. HPV infection is the biggest risk factor for cervical cancer, which is why vaccination is so important. The other major risk factor is smoking.  People living with HIV (PLHIV) are also considered more at risk, particularly with lower CD4 counts.  

Diagnosis

Cervical cancer screening aims to detect abnormal cells before they become cancerous, or detect cervical cancer early before symptoms arise. However, symptoms that may indicate cervical cancer include, vaginal bleeding after sex or between periods, pain during sex, unusual vaginal discharge, heavier or longer periods, or bleeding after menopause. If you are worried about these symptoms, please see your healthcare professional.  

Screening may involve an HPV test or an internal examination. The frequency of this test is individualised. Sometimes, blood tests, biopsies, and other minor procedures are required to sample or remove abnormalities. Treatment will depend on the stage of cervical cancer, how big it is, and whether it has spread, when diagnosed. Treatment may involve a combination of surgery, chemotherapy, and radiation.