In the United States, every six minutes a woman is diagnosed with some form of gynecologic cancer. Cancer can develop in several areas of the female reproductive tract, including the cervix, endometrium, fallopian tubes, ovaries, uterus and vagina. The symptoms and signs can vary depending on the type and location of the cancer, but the following are common signs to look for:
- A lump or mass in the pelvic area or vagina
- Difficult or painful urination
- Gastrointestinal issues, such as gas, bloating or constipation
- Pain during sexual intercourse, or vaginal bleeding after intercourse
- Pain, swelling or a feeling of fullness or pressure in the abdomen or pelvis
- Vaginal bleeding or discharge not related to menstrual periods
- Menstruation that is heavy or irregular
- Vaginal discharge that is clear, white, or tinged with blood
A slow developing form of cancer, cervical cancer is generally preceded by dysplasia abnormal cells appearing in the cervical tissue. Specific types of human papillomavirus (HPV) that are transmitted through sexual contact are the cause of almost all cervical cancers. The main types of cervical cancer are squamous cell carcinoma (developing in the thin, flat cells lining the cervix) and adenocarcinoma (developing in the cervical cells that make mucus and other fluids).
Uterine cancer that develops in the endometrium the inner lining of the uterus is also called endometrial cancer. Most uterine cancers are adenocarcinomas (cancers that begin in cells that make mucus and other fluids). Uterine sarcoma , an uncommon form of uterine cancer, forms in the muscle and tissue that support the uterus.
Ovarian, Fallopian Tube and Primary Peritoneal Cancer
Ovarian, fallopian tube and primary peritoneal cancers combined are the fifth-leading cause of cancer death in women in the U.S. Because they may not cause symptoms or exhibit early warning signs, they are often found at advanced stages. Risk factors for ovarian, fallopian tube and primary peritoneal cancers include having a family history of ovarian cancer or hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome), and having an inherited gene mutations such as BRCA1 and BRCA2 . Genetic tests that detect mutated genes may be conducted for family members with a high risk of cancer.
Vaginal cancer includes squamous cell carcinoma (the most common type), adenocarcinoma, melanoma and sarcoma. Vaginal cancer can be found during a routine pelvic exam and can be treated effectively when detected early. Certain factors can increase the risk of developing vaginal cancer including:
- Being age 60 or older
- Being exposed to DES (administered to women in the 1950s to prevent miscarriages)
- Having human papilloma virus (HPV) infection
- Having a history of abnormal cells in the cervix or cervical cancer
- Having a history of abnormal cells in the uterus or cancer of the uterus
- Having had a hysterectomy for health problems that affect the uterus
Vulvar cancer includes squamous cell carcinoma (the most common) and adenocarcinoma, with half of all vulvar cancers caused by infection with certain types of human papillomavirus (HPV). Vulvar cancer develops slowly and can be preceded by the growth of abnormal cells (vulvar intraepithelial neoplasia or VIN) on the surface of the vulvar skin. Signs of vulvar cancer typically include a lump, bleeding, or itching.
Screening Tests for Gynecologic Cancers
Not all gynecologic cancers have designated screening tests. The following tests may be used to determine if cancer is present or if there are certain types of abnormalities that could lead to cancer.
Screening women ages 30 and older with both the Pap test and the HPV test every five years finds more cervical abnormalities that can lead to cancer than screening with the Pap test alone. An HPV DNA test may also be used without a Pap test for screening in women ages 25 years and older.
The following are common screenings tests for gynecologic cancers: