Cervical Cancer

Health Concerns & Conditions

What is cervical cancer?
Cervical cancer develops in a typical female cervix (the entrance to the uterus from the vagina). Cancer is a disease in which cells in the body grow out of control.

What causes cervical cancer?

  • According to the WHO (2021), cervical cancer is the 4th most common cancer in typical females. Most cervical cancer cases are linked with high-risk human papillomaviruses (HPV), which are a common sexually transmitted infection. HPV can easily be prevented by taking the HPV vaccine.
  • There are more than 100 types of HPV, of which many are harmless. HPV 16 and 18 are two strains that cause abnormal changes in the cells of the cervix, which may lead to cervical cancer.
  • All typical females are at risk of developing cervical cancer. However, it occurs most often in persons over the age of 30.


What are the symptoms of cervical cancer?
Cervical cancer has no symptoms in its early stages. This is why screening of the cervix is important. Symptoms may include:

  • Abnormal vaginal bleeding (during or after sex).
  • Bleeding between periods.
  • Vaginal bleeding after menopause.
  • Persisting pelvic or back pain.
  • Unusual vaginal discharge and odour.

It is important to note that not all abnormal bleeding is related to cancer of the cervix, but it may need immediate attention from your medical practitioner.

Screening
Cervical cancer can be prevented through proper screening and early treatment. Screening, also known as a smear test, can detect cervical abnormalities. Further investigations by taking a cervical biopsy (colposcopy) and removing the abnormal cells can reduce the risk of developing cervical cancer.

  • Cervical screening is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the uterus).
  • Cervical abnormalities may not always lead to cancer.
  • HPV testing may be included for persons over 30 years of age.


Cervical Screening in Malta

  • The test is offered to all persons with female anatomical characteristics between 25 and 41 years of age (anyone who was born from 1980 onwards).
  • You will automatically receive an invitation from the National Screening Centre as part of the National Screening Programme.

The below are the most common risk factors that may lead to cervical cancer:

  • Smoking.
  • Being sexually active from an early age.
  • Having/had several sexual partners or having/had a sexual partner who has/had several other partners.
  • Taking immunosuppressant drugs (e.g. in case of organ transplant).
  • According to research, cervical screening under the age of 25 is not recommended and is considered to do more harm than good as younger persons are more likely to get rid of cervical abnormalities on their own.
  • After your first cervical screening, you will receive invitations every three years. When you reach the age of 50 you will be invited every five years.


If you have any questions about the service, you can:


What happens during cervical screening?
A nurse or a doctor will carry out your test. During the cervical screening, a small sample of cells is taken from the cervix by a small brush-like device. The picked cells are put into a small container or liquid and checked for abnormalities under a microscope in a lab. The same specimen may be tested for the presence of HPV if you are over 30 years old and have an abnormal result.

An abnormal cervical screening test result does not mean you have cancer.

Results

  • The nurse or doctor will tell you when you should expect to receive the results.
  • In case of an abnormal result, they may ask you to come back for more tests.
  • Most abnormal results are also tested for HPV (see above).
  • If you have borderline or mild changes found at screening, you may be asked to come back again after six months for a repeat test. This is routine for any person with borderline or mild changes if their screening sample has not been tested for HPV. Your result letter will let you know if you need to come back for another screening test.
  • In case you need a closer examination of the cervix, you may be asked to go to hospital/clinic for a 'colposcopy'. This is a procedure to closely examine your cervix, vagina, and vulva for signs of abnormalities. During the colposcopy, your doctor uses a microscope called a colposcope to check for cervical abnormalities.


Treating cervical cancer
If caught early, cervical cancer can be effectively treated by surgically removing part of the abnormal area from your cervix. However, after discussing your case, the gynaecologist may offer other surgical options. This can include a total hysterectomy. For advanced cervical cancer, chemotherapy and radio therapy may also be suggested.