cervical carcinoma

Last edited 10/2020 and last reviewed 12/2022

Despite the presence of well-organized cervical screening programmes in the UK and the introduction of HPV vaccination in 2008 for schoolgirls, the incidence of cervical cancer is not expected to significantly decrease over the next few years (1)

• over the last decade, cervical cancer incidence rates have increased by around 4% in females in the UK, although higher rates have been witnessed in Northern Ireland. Incidence rates for cervical cancer are projected to rise by 43% in the UK between 2014 and 2035, to 17 cases per 100,000 females by 2035

Cancer of the cervix often has no symptoms in its early stages and may be detected after an abnormal screening smear test

• symptoms can be subtle and attributed to benign gynaecological conditions or remain asymptomatic until the cancer has reached an advanced stage
  
  
• when symptomatic, the most common symptoms are abnormal vaginal bleeding, intermenstrual (IMB), postcoital (PCB) or postmenopausal bleeding (PMB)
• other symptoms of cervical cancer may include dyspareunia and abnormal vaginal discharge. Abnormal appearance of the cervix during examination should also raise suspicion and referral for further investigations (1)
  
  
• it is possible for women of all ages to develop cervical cancer, but traditionally the condition mainly affected sexually active women aged between 30 and 45 years of age, however, data from Cancer Research UK shows the peak age of incidence has reduced to 25-29 years of age


• cervical cancer is very rare in women under 25 years old and may be more difficult to prevent in younger age women (1)
  
  
• extra cervical advanced stage disease with spread into surrounding tissue and organs, it can cause other symptoms, including haematuria, urinary incontinence, bone pain, lower limb oedema, flank or loin pain (due to hydroureter or hydronephrosis), changes to bladder and bowel habits, loss of appetite, weight loss and fatigue

Reference:

• British Gynaecological Cancer Society (BGCS) Cervical Cancer Guidelines: Recommendations for Practice (Accessed 21/10/2020).
• Pretorius R, Semrad N, Watring W, Fotheringham N. Presentation of cervical cancer. Gynecol Oncol 1991;42(1):48-53.