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The cervix is the area of a female’s body between the vagina and uterus. When cells in the cervix become abnormal and multiply rapidly may develop to cancer, cervical cancer can develop and can be life-threatening if it goes undetected or untreated. Cancer of the cervix mostly tends occur during midlife. Half of the women diagnosed with the disease are women age 35 and older. It rarely affects women under age 20, and approximately 20 percent of diagnoses are made in women older than 65. For this reason, it is important for women to continue cervical cancer screening until at least the age of 70.
Cervical cancer usually found in the cells on the surface of the neck of the womb (mostly called uterine cervix) involving columnar or squamous cells. The cells mostly affected are squamous cells. Adenocarcinoma being the second cell that is common type of cervical cancer, Adenocarcinoma develops from the glands that produce mucus in the endocervix. While less common than squamous cell carcinoma, the incidence of adenocarcinoma is on the rise, particularly in younger women [29]. Colposcopy is a very effective, non-invasive diagnostic tool. In colposcopy, the cervix is examined non-invasively by a colposcope which is a specially designed binocular stereomicroscope. Most of the cervix cancer cases are preventable if diagnosed in early stages, by routine screening. Pap smear is the most common test used for cervical cancer screening but it is not a diagnostic test, it require further testing series e.g. Colposcopy, biopsy, endocervical scraping and cone biopsies. Following an abnormal Pap smear test, colposcopy is the important diagnostic method used to detect this disease. Although final diagnosis must be made on histopathological examination, colposcopy helps in reducing over treatment, determining abnormal cervical lesions, directing biopsy and in determining the location for biopsies [30].
The abnormal cervical regions turn to be white after application of 5% acetic acid [31].
Progression of pre-cancer lesions is usually slow and detection of early pre-cancer lesions can easily be achieved through screening test and is 100% treatable. Cervical cancer slowly turns to precancerous lesion to advanced cancer and eventually spread to adjacent organs such as the bladder, intestine, liver, ovaries, and uterus [32].
2.2.1 RISK FACTOR
Different cancers have various risk factors. The major risk factor for cervical cancer is infection with the sexually transmitted human papillomavirus (HPV), the two common types of HPV are considered low-risk and do not cause cervical cancer and high-risk HPV types may cause cervical cell abnormalities or cancer. More than 70 percent of cervical cancer cases can be attributed to two types of the virus, HPV-16 and HPV-18, often referred to as high-risk HPV types [3].
Weak immune system is another risk associating cervical cancer, due to human immunodeficiency virus (HIV) and other factors include smoking the risk of developing cervical cancer is doubled in smoking women compared to non-smokers due to exposure to high levels of carcinogens in smoke, using birth control pills for a very long time, having giving birth to many children and a family history of cervical cancer [32].
Cervical screening procedures and the data collection confirm that HIV-infected women are at higher risk of presenting a cervical screening test as well as histological precancerous lesions compared to HIV negative women, highlighting the need to extend cervical cancer screening to all HIV care clinics in West Africa
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