宫颈癌

宫颈癌是宫颈内膜异常细胞的生长。²

宫颈是女性生殖系统的一部分，其中还包括输卵管、子宫、卵巢、阴道（产道）和外阴（外生殖器）。¹

宫颈外表面开口到阴道内，内表面在宫颈管内。这两端的表面由两种类型的细胞覆盖：

• 鳞状细胞 – 平坦，覆盖宫颈（子宫颈）外表面的纤细状细胞。鳞状细胞的癌症称为鳞状细胞癌。
• 腺细胞 – 覆盖宫颈内表面的柱状细胞（子宫颈管或宫颈）。腺细胞的癌症称为腺癌

最常见的宫颈癌是 鳞状细胞癌，占到总病例的 80-85%。腺癌 则不太常见并且更难诊断，因为它在宫颈中的位置较高。²

尚无已知的宫颈癌遗传原因。¹

几乎所有宫颈癌都由 HPV 感染引起。虽然您不会遗传宫颈癌，但可能因为基因而更容易出现这种情况。例如，如有患有该疾病的母亲或姐妹的女性可能有更高的患病风险。目前尚不清楚这是否由遗传性疾病引起，这使得某些女性更容易感染 HPV 。³

通常使用 FIGO（国际妇产科联合会）系统进行宫颈癌分期。 ¹²

宫颈癌分为四个阶段，从一期到四期，表明癌症从轻度（I 期）到重度（IV 期）的发展程度。

在每个分期 (I—IV) 内，都有子分期，以 A 到 D 列出，描述了肿瘤的程度。

A risk factor is any factor that is associated with an increased chance of developing a health condition, such as cervical cancer.

Cervical cancer is not infectious. It is not caused by an inherited faulty gene, so other members of your family are not likely to be at risk of developing it.³

Risk factors for cervical cancer include:^1,2,9

• Smoking and passive smoking – Chemicals in tobacco can damage the cells of the cervix, making cancer more likely to develop in women with HPV.
• Long-term use of oral contraceptive (the pill) – Research has shown that women who have taken the pill for five years or more are at increased risk of developing cervical cancer. The reason for this is not clear. However, the risk is small and the pill can also help protect against other types of cancer, such as uterine and ovarian cancers.
• Having a weakened immune system – The immune system helps rid the body of HPV. Women with a weakened immune system have an increased risk of developing cervical cancer and need to have more frequent cervical screening tests. This includes women with the human immunodeficiency virus (HIV) and women who take medicines that lower their immunity.
• HPV infection – HPV is a common sexually transmitted infection which can be responsible for the development of many cancers and other conditions. Almost all cases of cervical cancer are caused by persistent infection with some high-risk types of the human papillomavirus (HPV); this is the biggest risk factor for cervical cancer. Around eight out of 10 women will become infected with genital HPV at some time in their lives. Most women who have the HPV infection never get cervical cancer; only a few types of the HPV result in cervical cancer.
• Age – It is very rare for women under the age of 25 to develop cervical cancer, with the risk increasing as you age.
• Sexual history – Several factors can increase your risk of cervical cancer, including becoming sexually active at a young age, having many sexual partners and having a partner who is considered high risk. This is primarily because of the increased risk of HPV infection.

Cervical cancer is most commonly caused by persistent infection with the human papillomavirus (HPV), with high-risk types of HPV responsible for around 70% of cervical cancers.⁸

The most important ways to prevent cervical cancer are:

• HPV vaccination – HPV vaccines protect against high-risk types of HPV which commonly cause cervical cancer. They are most effective when given before first sexual exposure and are recommended for women aged between nine and 26 years of age, or as advised by your doctor if above this age.⁷
• Screening – Cervical cancer screening is recommended for women aged 25 years and above. Depending on your age you may receive a Pap test or a HPV test, which test for changes in the cervix and the presence of high-risk types of HPV. It is important to ensure you receive cervical cancer screening at the recommended frequency (every three years for Pap tests and five years for HPV tests).⁶