Cervical cancer

Around 900 women/year die in the UK of cervical cancer.

Presentation includes:
  • post-coital bleeding
  • intermenstrual bleeding
  • post menopausal bleeding
  • finding on routine screening

In the UK all females aged 25 to 49 are invited for cervical smear tests to screen for cervical cancer every 3 years, then every 5 years from 50 to 65 years of age.

Around 5% of smears need to be repeated due to inadequate sample.

Risk of cervical cancer is increased in:
  • smokers
  • those with multiple sexual partners
  • younger age of first intercourse
  • women on immunosuppressant drugs

It is strongly associated with human papillomavirus, with HPV 16  implicated in 50% of cases and HPV 18 in 15% of cases. 

  • CIN (cervical intraepithelial neoplasia) 1 - can be managed by increased surveillance
  • CIN 2 or 3 - ablation or excision
  • invasive cancer - surgery, radiotherapy


Vaccination - girls aged 12/13 are given 3 doses of either 
  • cervarix – active against HPV 16 and 18 or
  • gardasil – active against HPV 6,11, 16 and 18

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