Synonyms in a broader sense
Synonyms in a broader sense: cancer at the entrance to the uterus, uterine cancer
Definition
This tumor/cancer is the second most common tumor in women after breast cancer. 20% of all new cancers are cervical cancers. It is assumed that cervical cancer is caused by wart viruses (human papilloma viruses).
HPV viruses belong to the papillomaviridae family. These uncoated DNA viruses are by no means all the same. There are over 100 different types that can cause different disease patterns.
The spectrum of possible diseases ranges from benign warts to malignant cancers such as cervical cancer or penis cancer. A distinction is made between so-called low-risk types, which include HPV types 11 and 6, and high-risk viruses, which include types 16, 18 and 33, for example. High-risk viruses can lead to the development of malignant diseases of the genital area, such as cervical cancer, penis/vulva and anal carcinomas.
But also cancers of the mouth and throat can be caused by these viruses. Low-risk viruses favour the development of benign warts. The transmission takes place mainly through sexual intercourse.
Condoms do not provide reliable protection against infection, since skin contact is sufficient for transmission. The virus remains in the body after infection and can lead to illness after several years. However, an infection can also heal, especially in young women.
Occurrence in the population (epidemiology)
Cervical cancer accounts for 20% of malignant cancers in women. It used to be one of the most common cancers. Today, this cancer, which affects about half a million women worldwide, is the second most common among malignant tumors.
Every year, ten to twenty new cases of cancer are diagnosed in the Federal Republic of Germany among 100,000 inhabitants. The frequency of occurrence is highest between the ages of 35 and 60. Preliminary stages can already occur at a younger age.
Anatomy and Histology
- Uterus – uterus
- Cervix – Fundus uteri
- Endometrium – tunica mucosa
- Uterine cavity – Cavitas uteri
- Peritoneal cover – Tunica serosa
- Cervix – Ostium uteri
- Uterine body – Corpus uteri
- Uterine constriction – Isthmus uteri
- Vagina – Vagina
- Pubic symphysis pubica
- Urinary bladder – Vesica urinaria
- Rectum – rectum
The cervix represents the part of the uterus leading from the vagina into the uterine body. The part of this cervix that protrudes into the vagina (i.e. the part further away from the body of the uterus) is called the portio and is the most common site of cervical cancer. This is due to natural changes in the cervical mucosa that take place during sexual maturity: under hormonal control, the cervical mucosa (which contains small glands that form an antibacterial mucus to protect against ascending infections) grows outwards towards the vagina.
Before puberty, the vagina is only covered by flat surface cells stacked on top of each other (so-called squamous epithelium). Due to these conversion processes, the mucous membrane of the front cervix (the portio, see above) is particularly sensitive to bacterial, mechanical, and other stimuli. Frequent inflammation therefore favors tumor development, which starts at the base of previously damaged cells.
The various types of pre-damage (collectively known as cervical intraepithelial neoplasias, or CIN for short, i.e. new formations of the cervix restricted to the superficial cell structure, and divided into stages from I to III depending on the extent of the cell changes) do not initially grow into the surrounding tissue (= invasive growth), but can be detected by smear examination and colposcopy (see below). However, according to the current state of knowledge, the disease is considered to be an example of cancer caused by viruses. Within the framework of extensive studies, it has been shown that infection with the Human Papilloma Virus (HPV) is a prerequisite for disease.The virus is transmitted through sexual intercourse.
Two of the approximately 200 different types of the human papilloma virus (HPV) pose a particularly high risk (types 16 and 18); other types of the virus (types 6 and 11) are responsible for genital warts (so-called condyloma acuminata). Human papilloma viruses are viruses in the broadest sense of the word that cause warts on the skin. However, an infection with the human papilloma virus is not necessarily linked to cervical cancer. Self-healing powers of the body prevent the outbreak of the disease in about 80% of all people infected with the virus. Poor hygiene and frequent changes of partners increase the probability of the disease, while male circumcision and childlessness reduce the risk.
All articles in this series:
