CERVICAL CANCER

Cervical cancer is a disease that posts 15,000 new cases per year.  This is a cancer that can be devastating in the fact that if it is serious enough, a hysterectomy may have to be performed, leaving a woman instantly sterile.  (Unrelated to smoking, a Pap smear can detect pre-cancerous cells in the cervix and can catch the cancer at an early stage.  It is very important that every woman over the age of 18 (or at the onset of sexual activity) go to her gynecologist and get a yearly Pap smear as this could eventually save her fertility and even her life!)  “Pre-cancerous changes of the cervix usually do not cause pain. In fact, they generally do not cause any symptoms and are not detected unless a woman has a pelvic exam and a Pap test.  Symptoms usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse, douching, or a pelvic exam. Menstrual bleeding may last longer and be heavier than usual. Bleeding after menopause also may be a symptom of cervical cancer. Increased vaginal discharge is another symptom of cervical cancer”³³.  Some pre-cancerous lesions will require treatment in which there are a few options such as use cryosurgery (freezing), cauterization (burning), or laser surgery to destroy the abnormal area without harming nearby healthy tissue.  It should be noted that some pre-cancerous lesions are called cervical intraepithelial neoplasia (or CIN for short); this will be brought up in some of the studies.  If there are cancerous lesions, most often these are treated with surgery or radiation therapy.  The invasiveness of the procedure is decided with the doctor and is based on such issues as what stage the cancer is in and if the woman is young, and still wants to have children in the future. 

There are an abundance of studies linking smoking with cervical cancer and the human papilloma viruses (HPV).  One of these studies focuses on the years after the treatment of CIN.  This study states that women who are current smokers have a 3-fold increase of treatment failure of CIN as compared to non-smokers.  This study also looked at HPV as a factor and determined that the risk increase associated with smoking is an independent risk¹.

A second study was to compare non-smokers and smokers perceptions of their risk toward cervical cancer and screening.  The study was conducted with 722 women.  It was found that even though smokers are aware of their increased risk of heart disease, they were not aware of their increased risk of cervical cancer.  It was determined that interventions at raising smokers’ awareness of their increased risk of cervical cancer and smoking cessation would be a benefit to their health²⁹.    

A study done in Kentucky, where the prevalence of smoking is very high, found that the rate of cervical cancer cases is high as well.  The Kentucky Cancer Registry shows that the incidence of invasive cervical cancer is as much as 40% higher than the SEER rate during the 1991-1998 time period.  A survey of Kentucky women with invasive cervical cancer during 1997-1998 shows that 61% of them indicated a history of tobacco use⁴⁹.  As an additional note a study found that smoking has an increased risk was associated with a greater incidence of cervical, vulvar, penile, anal, oral, and head and neck cancer in a does-dependent fashion³⁰.