As a genetic counselor, when taking a family history during a genetic counseling session often people will say their grandmother or another female relative died of a “female cancer”. To a genetic counselor, there is an important difference between the “female cancers”. Ovarian cancer is quite rare and is associated with several inherited cancer syndromes. While uterine cancer is more common compared to ovarian cancer, it also can be associated with a gene mutation which brings an increased risk of uterine cancer and colon cancer to some families. Cervical cancer, however, is typically not associated with inherited cancer syndromes and occurs sporadically or by the environment.
The cervix is the lower part of a female’s uterus or the organ where a fetus grows during pregnancy. The cervix connects the uterus to the vagina, and also plays a role in giving birth. Cervical cancer starts when the cells of the cervix change and become mutated, growing out of control. The majority of cervical cancer starts in a place called the transformation zone, which is where the two different parts of the cervix made up of different types of cells meet. In 2020, the American Cancer Society estimated that there would be 13,800 new cases of invasive cervical cancer and 4,290 women would die from cervical cancer.
Cervical cancer was at one point in time one of the most common causes of cancer death in American women. In the 1920s the development of the pap (Papanicolaou) test dramatically decreased female deaths by cervical cancer. The pap test is a procedure where a health care provider gently scraps cells from the cervix. Those cells are then sent to a lab and are examined for any abnormalities. In addition, the creation of the HPV (human papillomavirus) test has also helped prevent cervical cancer-related deaths. This test also looks at cervical cells and analyzes the DNA in those cells. Both of these tests aim to catch cervical cancer in the early stages when it is much more treatable.
The majority of cervical cancer cases are caused by HPV infection. HPV is a group of more than 150 related viruses. Some of these viruses more commonly cause the growth of warts or papillomas, but some of these viruses are high-risk types that can cause cancer. There are several risk factors associated with cervical cancer and becoming infected with HPV. Your sexual history can either increase or decrease your risk of cervical cancer. Smoking makes women twice as likely to develop cervical cancer. Having a weakened immune system, chlamydia infection, long term use of birth control pills, and having multiple full-term pregnancies can all increase the risk of developing cervical cancer.
While we still do not have known inherited cancer syndromes associated with cervical cancer or a known gene mutation, researchers are continuing to analyze families with more than one family member affected by cervical cancer. Some researchers suspect that there is an inherited condition that makes some women less able to fight off an HPV infection, which places them at higher risk to develop cervical cancer. If you have multiple family members affected by cervical cancer, it’s important to discuss your options with your health care provider.
There is currently an HPV vaccine available to women to prevent the spread of HPV. This vaccine is recommended for 11- and 12-year-old girls. If you have not yet had the vaccine, it is also recommended for women age 13 – 26 years of age. There are two doses of the vaccine that are recommended to prevent infection of most HPV types.
If you are interested in learning more about your cancer risks and discuss your family history, please contact AT-GC to meet with a genetic counselor.