Cervical Cancer

The cervix is the lower part of the uterus (womb) that connects to the vagina. Cervical cancer starts when cells on the surface of the cervix change abnormally — usually triggered by a persistent infection with certain high-risk strains of Human Papillomavirus (HPV). HPV is a very common virus spread through sexual contact; most people clear the infection naturally, but in some women the virus causes cell changes that — over 10–15 years — may develop into cancer. Cervical cancer is highly preventable through HPV vaccination and regular cervical screening.

Early cervical cancer often has no symptoms, which is why regular screening is essential. Seek medical attention if you experience:

Screening methods: VIA (Visual Inspection with Acetic Acid) — dilute acetic acid is applied to the cervix; abnormal areas turn white and can be treated immediately. Pap smear (Papanicolaou test) collects cells from the cervix to look for precancerous changes. HPV DNA testing identifies high-risk HPV strains. If screening is abnormal, a colposcopy (magnified examination of the cervix) and biopsy are performed. Imaging such as ultrasound, CT, or MRI may be used to assess the extent of disease.

Cervical cancer staging is based on the size of the tumour and how far it has spread. Stage I: Cancer is limited to the cervix. Stage II: Cancer has spread beyond the cervix but not to the pelvic wall or lower vagina. Stage III: Cancer extends to the pelvic wall or lower third of the vagina, or has blocked the ureters (tubes from the kidneys). Stage IV: Cancer has spread to the bladder, rectum, or distant organs. Stages I and II have much better outcomes than Stages III and IV.

Treatment depends on the stage of cancer. NCCN Guidelines recommend:

Cervical cancer is one of the most preventable cancers. Key actions: Girls aged 9–14 should receive the HPV vaccine (2 doses given 6 months apart) before becoming sexually active — this is the most powerful preventive step. Women aged 25–65 should be screened regularly: every 3 years with a Pap smear or every 5 years with an HPV DNA test. In Ethiopia, VIA screening combined with same-day cryotherapy treatment is available at many health centres. Precancerous changes can be easily treated, preventing progression to invasive cancer.

Treatment side effects may include fatigue, nausea, vaginal dryness, and bowel changes. Eating small, frequent nutritious meals helps manage nausea from chemotherapy. Pelvic floor exercises (Kegels) can help with bladder control after surgery. Regular follow-up examinations are essential — every 3–6 months for the first 2 years, then annually. Women who have had a hysterectomy can still develop vaginal cancer, so follow-up remains important. Counselling and peer support from other survivors is encouraged.