Understanding Cervical Cancer with Causes & Prevention –


Cervical cancer is a disease that starts in the cervix19. Human papillomavirus (HPV) causes approximately 100% of all cervical cancer cases13. Most HPV infections can clear on their own. However, when a female is infected with HPV and the virus doesn’t go away on its own, abnormal cells can develop in the cervix. If left untreated, these cells may develop into cervical cancer20.

In 2021, cervical cancer was the second most common cancer among Malaysian women between the ages of 15-4418.

Based on data in 2020, the disease is most common among women aged 40-64 but all ages are at risk once they are sexually active13.

Cervical cancer usually doesn’t produce symptoms21. Most women with early cervical cancers don’t know they have it until the cancer becomes aggressive and spreads into other tissue20. When this happens, some of these signs may begin to show21:

  • Bleeding between or following menstrual periods
  • Bleeding during or after sexual intercourse
  • Bleeding after menopause
  • Unusual vaginal discharge that is watery, bloody and foul-smelling
  • Pain or discomfort during sexual intercourse
  • Pain in the lower abdomen
  • Unexplained change in menstrual cycle

Staging is the common word used to describe where cancer is located or where it has spread and if it has affected other parts of the body22. Cervical cancer is staged using the TNM system23:

T (tumor): This describes the size of the original tumor.
N (node): This indicates whether the cancer is present in the lymph nodes.
M (metastasis): This refers to whether the cancer has spread to other parts of the body.

Once the T, N and M scores have been determined, an overall cervical cancer stage is assigned.

As a general rule of thumb, the lower the number, the less the cancer has spread. A higher number, such as stage 4, means a more advanced cancer. Cervical cancer stages can be broken down as below:

Stage 1 The cancer is limited to the cervix and has not spread to other parts of the body23.
Stage 2 The cancer is no longer limited to the cervix and uterus but has not reached the walls of the pelvis or the lower part of the vagina22.
Stage 3 The cancer has spread to the lower part of the vagina or the walls of the pelvis but not to distant sites. It may or may not affect the nearby lymph nodes24.
Stage 4 The cancer has spread to other nearby organs such as the bladder or rectum or other parts of the body such as the lungs or liver22.

Prior to Stage 1, there is also Stage 0 which is sometimes referred to as the pre-cancer stage. Pre-cancer is the stage where abnormal cells are detected on the surface of the cervix but have not moved to deeper layers of cells25. During this stage, various treatment options are available and have been proven effective in eliminating the cancerous cells25.

HPV Vaccination

The HPV vaccine helps protect you against some HPV types that are most likely to cause cervical cancer20.

Pap Smear Screening

A simple Pap smear every three years4, depending on your doctor’s recommendation, can easily help you avoid devastating HPV-related cancers and diseases.

Safe Sex

Using protection can reduce your chances of getting HPV, but they don’t protect you completely since some areas of the skin remained uncovered and are susceptible to infection26.

HPV DNA Testing27

A HPV DNA test can be conducted for high-risk HPV types that are most likely to cause cervical cancer by looking for pieces of DNA in cervical cells. This test can be done together with a Pap smear or by itself.

You can protect yourself

Getting infected with HPV is more common than you might think5. The good news is you can protect yourself through vaccination and regular cervical screening for women.


It can be hard to know what to say. Here are some helpful questions you can take to your next appointment.

Make an appointment

Find a clinic closest to you and set up an appointment to speak with your doctor about vaccination and screening.

MY-GSL-00237 Jan/2021