• HPV infection  HPV infections are very common. These viruses are passed from person to person through sexual contact. Most adults have been infected with HPV at some time in their lives, but most infections clear up on their own.
  
  Some types of HPV can cause changes to cells in the cervix. If these changes are found early, cervical cancer can be prevented by removing or killing the changed cells before they can become cancer cells.
  
  Now, a vaccine called Gardasil for females ages 9 to 26 can help protect against two types of HPV infection that cause 70 percent of cervical cancer.
• Lack of regular Pap tests Cervical cancer is more common among women who don't have regular Pap tests. The Pap test helps doctors find abnormal cells. Removing or killing the abnormal cells usually prevents cervical cancer.
• Smoking Among women who are infected with HPV, smoking cigarettes slightly increases the risk of cervical cancer.
• Weakened immune system (the body's natural defense system) Infection with HIV (the virus that causes AIDS) or taking drugs that suppress the immune system increases the risk of cervical cancer.
• Sexual history Women who have had many sexual partners have a higher risk of developing cervical cancer. Also, a woman who has had sex with a man who has had many sexual partners may be at higher risk of developing cervical cancer. In both cases, the risk of developing cervical cancer is higher because these women have a higher risk of HPV infection.
• Using birth control pills for a long time Using birth control pills for five years or more may slightly increase the risk of cervical cancer among women with HPV infection. However, the risk decreases quickly when women stop taking the Pill.
• Having many children Studies suggest that giving birth to five or more children may slightly increase the risk of cervical cancer among women with HPV infection.
• DES (diethylstilbestrol) DES may increase the risk of a rare form of cervical cancer in daughters exposed to this drug before birth. DES was given to some pregnant women in the United States between about 1940 and 1971. (It is no longer given to pregnant women.)

Having an HPV infection or other risk factors does not mean that a woman will develop cervical cancer. Most women who have risk factors for cervical cancer never develop it.
Symptoms

Precancerous lesions generally are not accompanied by any symptoms.  But once cancer has developed, women may notice one or more of these symptoms:

• Abnormal vaginal bleeding
• Bleeding that occurs between regular menstrual periods
• Bleeding after sexual intercourse, douching, or a pelvic exam
• Menstrual periods that last longer and are heavier than before
• Bleeding after menopause

• Increased vaginal discharge
• Pelvic pain
• Pain during sex

Infections or other health problems may also cause these symptoms. Only a doctor can tell for sure.
Detection and Diagnosis
Doctors recommend that women help reduce their risk of cervical cancer by having regular Pap tests. A Pap test (sometimes called Pap smear or cervical smear) is a simple test used to look at cervical cells. Pap tests can detect cervical cancer or abnormal cell changes that can lead to cervical cancer.
Finding and treating abnormal cells can prevent most cervical cancer. Also, the Pap test can help find cancer early, when treatment is more likely to be effective. The test should be done every year with a standard Pap smear, or every two years using a liquid-based test (such as ThinPrep), according to new guidelines from the American Cancer Society (ACS).
If you're 30 or older and have had three normal test results in a row, you may get screened every two to three years with your doctor's approval; recently, the U.S. Food & Drug Administration approved combining a Pap smear and an HPV test for women in this age group. That's because if you're diagnosed with HPV when you're older, you're more likely to have a strain of the virus that won't go away on its own and may lead to cancer, so you'll need to be monitored more regularly. If you're under 30, however, HPV tests are not useful, because HPV is so common in young women.
For most women, the Pap test is not painful. It's done in a doctor's office or clinic during a pelvic exam. The doctor or nurse scrapes a sample of cells from the cervix. A lab checks the cells under a microscope for cell changes. Most often, abnormal cells found by a Pap test are not cancerous. The same sample of cells may be tested for HPV infection.
If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis:

• ColposcopyThe doctor uses a colposcope, which combines a bright light with a magnifying lens, to look at the cervix. It is not inserted into the vagina. A colposcopy is usually done in the doctor's office or clinic.
• Biopsy Most women have tissue removed in the doctor's office with local anesthesia. A pathologist checks the tissue under a microscope for abnormal cells. Types of biopsy:

• Punch biopsy involves the use of a sharp tool to pinch off small samples of cervical tissue.
• LEEP involves the use of an electric wire loop to slice off a thin, round piece of cervical tissue.
• Endocervical curettage scrapes a  small sample of tissue from the cervix with a curette (a small, spoon-shaped instrument). Some doctors use a thin, soft brush instead of a curette.
• Conizationinvolves the removal of a cone-shaped sample of tissue. A conization, or cone biopsy, lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia.

Removing tissue from the cervix may cause some bleeding or other discharge. The area usually heals quickly. Some women also feel some pain similar to menstrual cramps.