As with most cancers, cervical cancer causes no pain or other symptoms in its early stages. The first identifiable symptoms of the disease are likely to include:
*  watery or bloody vaginal discharge.
*  vaginal bleeding after intercourse, between menstrual periods, or after menopause; periods may be heavier and last longer than normal.

If the cancer has spread symptoms may include:
*  difficult and painful urination and possible kidney failure.
*  blood in urine.
*  dull backache or swelling in the legs.
*  diarrhoea, or pain or bleeding from the rectum upon defecation.
*  fatigue, loss of weight and appetite, and general feeling of illness.

The cervix is the neck of a woman's womb. In some women, healthy cells enter an abnormal phase called dysplasia; although these cells are not cancerous, they can become so. When dysplastic cells turn malignant some may invade the lining of the cervix itself, spread to nearby tissue, and enter the bloodstream or lymphatic system.

It usually takes many years for dysplasia to become carcinoma, and from there it often takes months or sometimes even years for cervical cancer to become invasive. Because of this long time factor, and also because of the Pap smear, cervical cancer is becoming less threatening. When caught early, it is curable.

Causes

Many cases of cervical cancer are linked to sexually transmitted viral infections, such as genital herpes and some strands of the human papilloma viruses (HPV) that often cause genital warts.

But these are not always indicative of the likelihood of developing these types of cancers as many women who have a sexually transmitted viral infection do not develop cervical cancer, while others who get cancer have never had such infections.

Slightly more at risk are women who began having sexual intercourse before age 18, have had many sexual partners, have had several full-term pregnancies, or have a history of sexually transmitted disease. Genetics can also play a role in the development of cervical cancer.

Cervical cancer is also more common among women who smoke. Women with weaker immune systems, caused by other diseases, by treatments, or by organ transplants are more vulnerable to cervical cancer. Women who are obese or who use birth-control pills may be at slightly increased risk.

Every woman should have an annual Pap smear, which tests a cervical cell sample for abnormalities. This screening test can usually detect abnormal cells 95 percent of the time, often long before the disease produces symptoms.

If your Pap smear is abnormal your doctor will advise on the next steps and may also refer you to a specialist for treatments.

Treatment

Most cases of cervical cancer are cured by a combination of surgery, chemotherapy, and radiation therapy. (See Cancer for more information on therapies).

Women with genital warts and mild dysplasia should be carefully monitored for signs of cancer but usually require no immediate treatment. You should continue to have pap smears every 6 months to ensure the condition does not worsen. Severe dysplasia, and mildly invasive cancers are normally treated surgically.

If cancer has spread deep into the cervix or to organs close by, hysterectomy (removal of the cervix, uterus, and possibly other organs) is imperative. If cancer spreads beyond the pelvic area, radiation therapy and perhaps chemotherapy suppress the spread but rarely result in cure. It is important to have regular check ups if you have had cervical cancer or severe dysplasia.

Lifestyle and personal care

you are a woman over age 18, or are under 18 and sexually active, have a pelvic exam and Pap smear yearly.

Speak with your doctor about the benefits of different types of contraception - some may be less of a risk than others with relation to cervical cancer.

When to seek further professional advice:
*  abnormal bleeding, discharge, or any other symptoms last more than two weeks without explanation