• Cervical cancer is the eighth most common cancer among female in Hong Kong, accounting for 3% of all new cancer cases in female in 2019
• It is the eighth leading cause of female cancer deaths in Hong Kong with 162 deaths in 2019. This accounts for 2.6% of all female cancer deaths
• Most cervical cancers are caused by one of the cancer-causing (or high-risk) human papillomavirus (HPV) types. There are more than 150 genotypes for HPV and around 40 of these viruses infect the genital area. Most women with HPV infection do not have any symptoms and the infection will clear on their own. Some women with persistent high-risk HPV infection in the cervix may develop abnormal (pre-cancerous) cell changes

The cervix connects the uterus to the vagina in the female reproductive system.

The surface of the cervix is covered by two types of cells. The cell your cervical cancer develops from determines the type of cervical cancer you have:

• Squamous cells – line the outer surface of the cervix (ectocervix). Cancer that develops from squamous cells is known as squamous cell carcinoma and is the most common type of cervical cancer (accounting for more than 80% of cases)
• Glandular cells – line the inner surface of the cervix (cervical canal or endocervix). Cancer of these cells is called adenocarcinoma. Adenocarcinoma is less common than squamous cell carcinoma

Other rare tumours of the cervix include small cell carcinomas, lymphoma, sarcoma, melanoma and mixed carcinomas (adenosquamous) which contain both squamous and glandular cells.

As signs and symptoms for cervical cancer can be similar to other common conditions, it’s important to see your GP or healthcare professional if you experience any of the symptoms below. Discussing anything concerning with your doctor as soon as possible can help give you peace of mind and offer the best chance of successful treatment if you receive a cervical cancer diagnosis.

Symptoms include:

• Vaginal bleeding between periods
• Pain or bleeding during or after sexual intercourse
• Changes in vaginal discharge
• Vaginal bleeding after menopause
• Pelvic pain
• Blood in urine or pain during urination (if urinary system is affected)
• Leg swelling (if lymphatic system is affected)
• General tiredness and weight loss

As early stages of cervical cancer may present no symptoms at all, it is important to receive regular cervical screening tests which can determine if there are any abnormal or cancerous cells in the cervix.

The TNM system is used to stage cervical cancer, and it helps doctors plan your treatment. The TNM stands for:

• Tumour (T) – the degree to which the tumour has affected other tissue, for example how much of the cervix and surrounding tissue has been affected
• Nodes (N) – is a measure of whether lymph nodes have been affected
• Metastasis (M) – whether the cancer has spread to other parts of the body

The TNM information, along with other tests, helps determine the stage of your cervical cancer using the classifications below:

• Stage I – The cancer is confined to the tissue of the cervix
• Stage II – The cancer has spread out of the cervix to the upper two-thirds of the vagina or other tissue next to the cervix
• Stage IVa – The cancer has spread to surrounding pelvic organs, including the bladder or rectum
• Stage IVb – The cancer has spread to beyond the pelvis, such as to the lungs, liver or bones