Cancer of the uterine cervix can be detected very early in its oncogenesis. Oncogenesis is the medical term meaning the process of promoting and progressing to full fledged cancer. When detected early usually by Papanicolaou (Pap) smear, it is curable.

It is now proven that cancer of cervix is caused by human papilloma virus (HPV). Other associative factors are coitus at an early age, many sexual partners, genital herpesvirus infections, multiparity, and poor obstetric and gynecologic care. These patients have higher incidence of HPV infections. Early cervical cancer has no symptom, but there may be a watery vaginal discharge or occasional spotting of blood. Late cancer of cervix may cause a dark, foul-smelling vaginal discharge, leakage from bladder or rectal fistulas, anorexia, weight loss, and back and leg pains depending on which patho-physiological sites are affected In addition, patients with advanced cancer of cervix may have symptoms and signs of para-neoplastic complications.

Pap smears of cervical cells are highly important in screening. Confirmatory diagnoses are based on colposcopic examination and cytologic study of specimens obtained by biopsy. Suitable sites for biopsy may be indicated by applying 3% acetic acid to the cervix to accentuate characteristic changes in neoplastic epithelium or by using Schiller's test in which an iodine solution stains normal cervical cells dark brown and does not stain the nonglycogen-producing cells of malignant epithelium. Cervical dysplasia may regress, persist, or progress to clinical disease, but carcinoma in situ is considered to be a precursor of invasive carcinoma. About 90% of cervical cancers are squamous cell carcinomas, fewer than 10% are adenocarcinomas, and others are mixtures of these kinds, or, in rare cases, sarcomas. Cancers on the surface of the cervix may be huge, polypoid masses whereas endophytic lesions tend to be small and hard; ulcerative lesions may cause extensive erosion. Cervical cancer invades the tissues of adjacent organs and may spread through lymphatic channels to distant sites, including the lungs, bone, liver, brain, and para-aortic nodes. Treatment depends on the kind and the extent of the malignancy, the age of the woman, and her general health. Also considered are her wishes in regard to maintaining her reproductive function. Carcinoma in situ may be treated by excisional conization or cryosurgery. Invasive tumors may be treated with radium implants or with radiotherapy or vaginal or abdominal hysterectomy. Radical hysterectomy is an American invention. It is a accepted palliative approach in modern medicine.

A new vaccine is now available. This quadrivalent vaccine known as Gardasil,  is marketed by Merck Pharmaceuticals. This vaccine protects girls against four subtypes of human papilloma virus.

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