Cervical Cancer

Cervical cancer is minimally symptomatic in its early stages.

However, bleeding outside of menstruation, as well as bleeding or pain during sexual intercourse, can be early signs of the disease.

HPV is a sexually transmitted virus. There are several types of the virus, some of which are oncogenic (capable of causing cancer).

Up to 80% of women will come into contact with this virus during their lifetime, but in most cases, it disappears spontaneously thanks to the immune system.

If the infection persists, it can lead to precancerous lesions on the lining of the cervix, which may develop over time into invasive cancer.

This process takes several years, making cervical cancer screening very effective.
A cervical-vaginal smear is recommended every 3 years from age 25 and every 5 years from age 30 to detect the virus or precancerous lesions.

HPV infections can largely be prevented through vaccination. The vaccine against the most common oncogenic HPV types could prevent 90% of cervical cancer cases. Since this virus is sexually transmitted, vaccination is recommended before the onset of sexual activity. In Belgium, vaccination is not mandatory but is recommended for adolescents (girls and boys) at 13–14 years old.

As with any sexually transmitted disease, using condoms reduces the risk of virus transmission.

If abnormalities are found in a screening smear, a colposcopy is performed, followed by a biopsy if the colposcopy appears abnormal.

In the case of precancerous lesions, a conization may be proposed. This surgical procedure involves removing a portion of the cervix. It is performed through the natural passageways and not only treats the precancerous lesion but can also sometimes detect an invasive cancer that was not identified by the biopsy.

A pelvic MRI and sometimes a PET scan will be indicated if cancer is detected, in order to stage the disease and propose the most appropriate treatment(s).

Early-stage cervical cancer is treated surgically. A hysterectomy (removal of the uterus) is performed. Sometimes, in the presence of risk factors for recurrence, radiotherapy combined with chemotherapy may be recommended after surgery.

In locally advanced stages (if the tumor is large or extends to lymph nodes or adjacent organs), the recommended treatment combines radiotherapy and chemotherapy, sometimes together with immunotherapy.