What is cervical cancer?
Cervical cancer is an abnormal growth of cells arising in the cervix uteri (the neck of the womb). There are two main types of cervical cancer: squamous cell cancer, which affects cells that cover the outer surface of the cervix, and adenocarcinoma, which affects the endocervical canal (the passageway leading to the womb). Squamous cell cancer is the more common of the two (Cancer Research UK, 2013).
Incidence and mortality have decreased over the past 40 years
Cervical cancer is the most common cancer among women aged 15–34 and is accountable for 16% of all cancers diagnosed in this age group. Unlike the majority of cancers, it is primarily a disease of the young with 62% of registrations in those aged 50 or below and a peak age of diagnosis in those aged 25-29 (Office for National Statistics, 2013a).
Figure 1: Registrations of newly diagnosed cases of cervical cancer by age group, females, England, 2011
In 2011, there were around 2,500 newly diagnosed cases of cervical cancer in England. The incidence rate has decreased from 15 new cases per 100,000 women in 1971 to 9 new cases per 100,000 women in 2011. This amounts to a 43% decrease over this time period.
In 1988 the National Cervical Cancer Screening Programme was introduced. This invites all women in England aged 25 to 64 to be screened every three to five years. The aim is to detect and treat early abnormalities which, if left untreated, could lead to cervical cancer (National Cancer Intelligence Network, 2011). Figure 2 shows that following the introduction of the screening programme in 1988 there was a notable decrease in incidence rates.
In 2011, around 800 women died of cervical cancer. The mortality rate has decreased from eight deaths per 100,000 women in 1971, to two deaths per 100,000 women in 2011. This represents a 70% decrease in mortality over the past 40 years.
Figure 2: Cervical cancer incidence rates, England, 1971-2011
- Cervical Cancer is coded as 180 in the International Classification of Diseases Eighth Revision (ICD-8), 180 in the International Classification of Diseases ninth Revision (ICD-9) and as C53 in the Tenth Revision (ICD-10).
- Age-standardised rates allow comparisons between areas or over time where populations have different age structures. The method used here is direct standardisation using the 1976 European Standard Population.
Risk factors associated with cervical cancer
One of the strongest risks factors for cervical cancer is human papillomavirus (HPV). Two strands of HPV are known to be responsible for 70% of all cases of cervical cancer: HPV 16 and HPV 18 (NHS Choices, 2013). Research has suggested that cervical cancer cannot develop without the presence of HPV (Parkin, 2011).
HPV is a very common infection that is often spread through sexual contact, and as a result, as much as half of the population will be infected at some point in their lifetime. Although for the vast majority of people HPV will be harmless, for some women it will lead to the development of cervical cancer. There is evidence to suggest that young women are more susceptible to developing cervical cancer. This is enhanced in females who have sexual intercourse at an early age, and can be related to the amount of sexual partners someone may have (Deacon, Evans, Yule, 2000).
In 2008, as part of the NHS childhood vaccination programme, the HPV vaccination was introduced routinely to all girls aged 12 to 13 in England. The aim is to provide effective protection against the majority of HPV viruses which subsequently could lead to cervical cancer (NHS Choices, 2013).
Other risk factors for cervical cancer are young age at first full term pregnancy and increasing duration of oral contraceptive use (Berrington de González, 2007).
Survival has improved since 1971
For women (aged 15–99 years) diagnosed with cervical cancer between 2007 and 2011 and followed up to 2012, the five year survival estimate was 67% (Office for National Statistics, 2013b). In comparison, among women diagnosed between 1971 and 1975 and followed up to 1995, only 50% survived for five years or more (Coleman, et al. 1999). This represents an increase of 17 percentage points for women diagnosed with cervical cancer across this time period (Office for National Statistics, 2013b).
These statistics were compiled and analysed by the Cancer and End of Life Care Analysis team in the Life Events and Population Sources Division. If you’d like to find out more about our cancer statistics you can read our Annual Reference Volume and see further stories, for example on Pancreatic Cancer. If you have any comments or suggestions, we’d like to hear them. Please email us at: email@example.com.
Berrington de González A. Comparison of risk factors for squamous cell and adencarcinomas of cervix: a meta-analysis. Br J Cancer 2004; 90(9):1787-91.
Coleman MP, Babb P, Damiecki P, Grosclaude P, Honjo S, Jones J, et al. (1999). Cancer survival trends in England and Wales, 1971-1995: deprivation and NHS region. London: Stationery Office.
Cancer Research UK, Cervical Cancer, 2013.
Deacon JM, Evans CD, Yule R, et al. Sexual behaviour and smoking as determinants of cervical HPV infection and CIN 3 among those infected. A case-control study nested within the Manchester cohort. Br J Cancer 2000; 83:1565-1572.
National Cancer Intelligence Network, 2011 Cervical Cancer Incidence and Screening coverage.
NHS Choices, 2013 Cervical Cancer.
Office for National statistics (2013a) Cancer Registration Statistics, England, 2011.
Office for National Statistics, (2013b) Cancer Survival in England: Patients Diagnosed 2007-2011 and Followed up to 2012.
Parkin DM. Cancers attributable to infection in the UK in 2010 Br J Cancer 2011; 105(S2):S49-S56.