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Understanding Cervical Changes: A Health Guide for Women

  • Posted: 01/21/2010

What Is the Cervix?


Common Changes in Cervical Cells
Cell Changes Caused by HPV Are a Special Concern
Other Risk Factors for Cervical Cancer

The cervix

It is important to get a Pap test at least once every 3 years to check for changes that could be cancer.

The cervix is the narrow, lower part of the uterus where it connects to the upper end of the vagina.

The passageway through the cervix is called the endocervical canal. This passageway lets blood flow from the uterus into the vagina during a woman's menstrual period. During childbirth, it opens much wider to let the baby pass through.

The inner lining of the cervix has two different types of cells:

  • Tall cells, called glandular cells (or columnar cells) toward the top of the endocervical canal. They make mucus, which helps guard the entrance to the uterus.
  • Thin, flat cells, called squamous epithelial cells (or squamous cells). Arranged in layers, they protect the tissues beneath them.

Pap tests can help reveal changes in these cells.

Cells of the cervix, glandular and squamous epithelial
Normal cervical cellsMix of normal and precancerous cellsPrecancerous cervical cells
Normal cervical
cells		Mix of normal and
precancerous cells		Precancerous
cervical cells

Common Changes in Cervical Cells

Cervical cells can go through many types of changes that are not cancer. These changes can be caused by:

Although many cervical cell changes are very common and not related to cancer, they sometimes make cervical cells look like abnormal cells. So your health care provider may suggest that you repeat your Pap test or have other follow-up tests to be certain that the cell changes are not cancer. (See the tables beginning at Table 1 1 for more information.)

Cell Changes Caused by HPV Are a Special Concern

Some cervical cell changes are caused by infection with a virus called HPV (human papillomavirus). Most HPV infections eventually go away, or clear, on their own, but sometimes they do not. In infections that do not clear, the HPV-infected cells may become precancerous. If these precancerous cells are not detected and treated early, they can develop into invasive cancer of the cervix. An HPV test can detect the virus in cervical cells.

What is HPV?
  • It is a very common virus.
  • There are more than 100 types.
  • Some types cause benign warts on the fingers or feet.
  • More than 30 types can be transmitted sexually.
  • About 15 sexually transmitted types, called high-risk types, can cause cervical cancer.
  • Some other sexually transmitted types, called low-risk types, cause external warts on the genitals that are not cancerous.

Other Risk Factors for Cervical Cancer

An ongoing, or persistent, infection with a high-risk HPV type is the most important cause of and risk factor for cervical cancer. However, studies have shown that other factors may act together with HPV to increase a woman's risk of developing cervical cancer. These factors include cigarette smoking, having given birth to many children, and use of birth control pills for five or more years. Also, if you have a weak immune system, you may be at higher risk because your body may not be able to clear HPV infections on its own. For example, if you take medicine to block your body's immune response or if you are infected with HIV, you may be at higher risk of developing cervical cancer.



Glossary Terms

abnormal (ab-NOR-mul)
Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
bacteria (bak-TEER-ee-uh)
A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.
benign (beh-NINE)
Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant.
cyst (sist)
A sac or capsule in the body. It may be filled with fluid or other material.
genital (JEH-nih-tul)
Refers to the genitalia (external and internal sex organs and glands).
HIV
The cause of acquired immunodeficiency syndrome (AIDS). Also called human immunodeficiency virus.
hormone (HOR-mone)
One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
HPV
A type of virus that can cause abnormal tissue growth (for example, warts) and other changes to cells. Infection for a long time with certain types of HPV can cause cervical cancer. HPV may also play a role in some other types of cancer, such as anal, vaginal, vulvar, penile, oropharyngeal, and squamous cell skin cancers. Also called human papillomavirus.
human papillomavirus (HYOO-mun PA-pih-LOH-muh-VY-rus)
A type of virus that can cause abnormal tissue growth (for example, warts) and other changes to cells. Infection for a long time with certain types of human papillomavirus can cause cervical cancer. Human papillomavirus may also play a role in some other types of cancer, such as anal, vaginal, vulvar, penile, oropharyngeal, and squamous cell skin cancers. Also called HPV.
immune response (ih-MYOON reh-SPONTS)
The activity of the immune system against foreign substances (antigens).
immune system (ih-MYOON SIS-tem)
The complex group of organs and cells that defends the body against infections and other diseases.
infection (in-FEK-shun)
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
inflammation (IN-fluh-MAY-shun)
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
invasive cancer (in-VAY-siv KAN-ser)
Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.
menopause (MEH-nuh-pawz)
The time of life when a woman’s ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.
menstrual period (MEN-stroo-ul PEER-ee-ud)
The periodic discharge of blood and tissue from the uterus. From puberty until menopause, menstruation occurs about every 28 days, but does not occur during pregnancy.
mucus (MYOO-kus)
A thick, slippery fluid made by the membranes that line certain organs of the body, including the nose, mouth, throat, and vagina.
polyp (PAH-lip)
A growth that protrudes from a mucous membrane.
precancerous (pree-KAN-seh-rus)
A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant.
risk factor (... FAK-ter)
Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.
squamous cell (SKWAY-mus sel)
Flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
uterus (YOO-teh-rus)
The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called womb.
vagina (vuh-JY-nuh)
The muscular canal that goes from the uterus to the outside of the body. During birth, the baby passes through the vagina. Also called birth canal.
viral (VY-rul)
Having to do with a virus.
wart (wort)
A raised growth on the surface of the skin or other organ.

Table of Links

1http://www.cancer.gov/cancertopics/understandingcervicalchanges/page9