Cervical Conditions

Cervical
Conditions

Cervical conditions encompass a variety of disorders affecting the cervix, the lower part of the uterus that connects to the vagina.

These conditions can range from infections and inflammation to precancerous changes and cancer.

Regular cervical screening is crucial for early detection and management of these conditions, which can significantly impact a woman’s health and fertility.

In Australia, the National Cervical Screening Program (NCSP) plays a vital role in reducing the incidence and mortality of cervical cancer through regular HPV (human papillomavirus) testing.

Human papillomavirus (HPV)

Human papillomavirus (HPV) is a group of more than 200 related viruses, with over 40 types that can infect the genital areas, mouth, and throat. HPV is the most common sexually transmitted infection (STI) globally, including in Australia. While strainsinfections are harmless and resolve on their own, some are responsible for genital warts whilst others some can lead to serious health problems, including cervical cancer.

Causes: HPV is primarily transmitted through intimate skin-to-skin contact during vaginal, anal, or oral sex with someone who has the virus. It can be transmitted even when an infected person shows no signs or symptoms. In rare cases, a mother can transmit HPV to her baby during childbirth.
Symptoms: HPV often goes unnoticed because it typically does not cause symptoms. However, when symptoms do occur, they can include:
- Genital Warts: Small bumps or groups of bumps in the genital area.
- Respiratory Papillomatosis: Rare warts growing in the throat, causing breathing difficulties.
- Precancerous Changes: Detected through cervical screening tests.
- Cervical Cancer: Abnormal vaginal bleeding, unusual discharge, and pelvic pain, often with no early symptoms.

Risk Factors: Increased risk factors include:
- Multiple Sexual Partners: Higher likelihood of HPV infection.
- Early Sexual Activity: Starting sexual activity at a young age.
- Weakened Immune System: Due to HIV/AIDS, immunosuppressive drugs, or other conditions.
- Smoking: Heightened risk of HPV infection and cervical cancer.
- Other STIs: Having other sexually transmitted infections.

Treatment Options: No cure exists for HPV itself, but treatments are available for related health issues:
- Genital Warts: Prescription creams, cryotherapy, electrocautery, and surgical removal.
- Precancerous Cervical Changes: Cryotherapy, laser therapy, and loop electrosurgical excision procedure (LEEP).
- Cervical Cancer: Surgery, radiation therapy, chemotherapy, or a combination.

Prevention: Preventing HPV involves vaccination, regular screening, and safe sexual practices.
- HPV Vaccination: Part of the National Immunisation Program in Australia, offered to boys and girls aged 12-13 years in schools.
- Regular Cervical Screening: The National Cervical Screening Program (NCSP) recommends a Cervical Screening Test every five years for women aged 25 to 74 who have ever been sexually active.
- Safe Sexual Practices: Using condoms and dental dams, limiting the number of sexual partners, and maintaining mutually monogamous relationships.

National Cervical Screening Program (NCSP)

The NCSP in Australia recommends regular cervical screening tests for women aged 25 to 74 who have ever been sexually active.

The screening test checks for HPV infection, which can lead to cervical cell changes and cervical cancer. The introduction of the HPV vaccine has also significantly contributed to reducing the incidence of cervical cancer.

Cervical Dysplasia

Cervical dysplasia involves abnormal changes in the cells on the surface of the cervix, which can be detected through cervical screening tests.

Causes: The primary cause is persistent infection with high-risk strains of HPV.
Significance: HPV can predispose you to dysplasia, which can predispose you to cervical cancer
Symptoms: Cervical dysplasia typically has no symptoms and is usually detected during routine cervical screening.
Risk Factors: Risk factors include HPV infection, early sexual activity, multiple sexual partners, smoking, and a weakened immune system.
Treatment Options: Treatment depends on the severity. Low-grade changes requiring monitoring with more frequent screening and occasional colposcopy. High-grade changes require treatment such as laser therapy, loop electrosurgical excision procedure (LEEP) and cone biopsy.

Cervicitis

Cervicitis refers to inflammation of the cervix, often caused by infections, irritants, or allergies.

Causes: The primary causes include sexually transmitted infections (STIs) such as chlamydia, gonorrhoea, and herpes. Non-infectious causes can include allergies to spermicides or latex condoms, and irritation from tampons or douches.
Symptoms: Symptoms may include abnormal vaginal discharge, bleeding between periods or after intercourse, pain during intercourse, and pelvic pain.
Risk Factors: Risk factors include unprotected sex, multiple sexual partners, and a history of STIs.
Treatment Options: Treatment depends on the cause. Antibiotics are prescribed for bacterial infections, antiviral medications for viral infections, and avoiding irritants for non-infectious cervicitis.

Cervical Polyps

Cervical polyps are small, benign growths on the cervix.

Causes: The exact cause is unknown, but they may be linked to inflammation, hormonal changes, or clogged blood vessels in the cervix.
Symptoms: Many women with cervical polyps are asymptomatic. When symptoms do occur, they may include abnormal vaginal bleeding (after intercourse, between periods, or after menopause) and unusual discharge.
Risk Factors: Risk factors include being over 40 years old, having multiple pregnancies, and high oestrogen levels. Polyps sometimes run in families, and you may find you have them in other parts of your body.
Treatment Options: Polyps are usually removed during a simple outpatient procedure. While most polyps are benign, they are often sent for pathological examination to rule out malignancy.

Cervical Cancer

Cervical cancer is a malignant tumour arising from the cervix, most commonly caused by persistent infection with high-risk HPV types.

Causes: The primary cause is chronic infection with high-risk HPV strains. Other factors may contribute, including smoking, long-term use of oral contraceptives, and a compromised immune system.
Symptoms: Symptoms may include abnormal vaginal bleeding (after intercourse, between periods, or after menopause), unusual discharge, pelvic pain, and pain during intercourse.
Risk Factors: Risk factors include HPV infection, smoking, early sexual activity, multiple sexual partners, long-term use of oral contraceptives, and a family history of cervical cancer.
Treatment Options: Treatment depends on the stage of cancer and may include surgery, radiation therapy, chemotherapy, or a combination of these. Early-stage cervical cancer can often be treated successfully with surgery alone.

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