Often in the news, cancer of the cervix is still a concern for the insurance sector, as Mary Randall explains.
Every year in the UK more than 3,000 women are diagnosed with cervical cancer, with it being most common in women under the age of 35.
There are two main types of cervical cancer: Squamous cell carcinoma (when the skin-like cells on the outer surface of the cervix become cancerous); and adenocarcinoma (when the glandular cells lining the inside of the cervix are affected). Squamous cell carcinoma of the cervix is the most common type.
Causes and risk factors
Human Papilloma Virus infection (HPV) has now been identified as being the main cause of squamous cell and adenocarcinoma of the cervix. There are more than a hundred different types of HPV, half of which are sexually transmitted. The wart virus is included in this group. However, genital warts on their own do not generally cause abnormalities in the cells lining the cervix.
HPV infection is very common, and most of the time it causes no harm and disappear on its own. However, research has found about 15 types of HPV that are a high risk, with two being responsible for 70% of all cervical cancers.
Recently, a vaccine was developed that protects against most of the high-risk strains of the virus, and girls in the UK are now routinely vaccinated before they become sexually active.
Research has also found that women who have both HPV infection and herpes have double the risk of developing squamous cell carcinoma of the cervix, while those with HPV and Chlamydia increase their risk by about 80%.
Like many other conditions, smoking also increases the risk. It is thought that benzyrene, a chemical in cigarettes, damages the cells in the cervix. An industrial chemical, tetrachloroethylene, has also been linked to cervical cancer in a small number of cases.
Studies have shown that genetics may also play a part. Women with a first-degree relative with cancer of the cervix have double the risk of developing squamous cell or adenocarcinoma of the cervix themselves.
However, it is not yet clear whether this is due to a faulty gene or from following similar lifestyles. In some instances, it may be due to the HPV infection being passed on during pregnancy.
About four million women undergo cervical screening each year in England, and it has been found that routine three- yearly smear tests prevent more than 80% of women between the ages of 25 and 50 from developing cervical cancer. Of all tests, 90% are found to be normal, with one in every 200 showing severe changes. One in 1,000 tests pick up invasive cancer.
Screening can pick up a number of cell changes and further investigations or treatment depends on the nature and severity of the changes found.
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