Cervical Cancer

Cervical cancer (click on a topic)
introduction and statistics
causes of cervical cancer
histopathology and natural course of cervical cancer
tumor behavior
screening for cancer of the cervix (Pap test and pelvic exam)
symptoms of cervical cancer
diagnostic tests (Pap test, colposcopy, cervical conization, other tests)
staging of cervical cancer
treatment of cervical cancer
newest developments with cervical cancer
summary

Introduction and statistics:

Cancer of the cervix is the 3rd most common cancer of the gynecological cancers in women. Fortunately there has been a dramatic improvement from the past: those women, who get checked regularly with yearly Pap tests, will not progress to invasive cervical cancer, but will have their precancerous lesions removed. If a woman had 3 or more satisfactory Pap test readings at yearly intervals, the Pap test can be performed less frequently at the discretion of her treating physician, if she belongs into the low-risk category.

Low-risk and high-risk parameters  for decision on frequency of Paptest
Low-risk group:At-risk group:
Never had sex (e.g. nuns) Age 18 and older
Had hysterectomy for non-cancerous diseaseSexually active
Age 60 or older after regular Pap screen without abnormal smearHigh-risk subgroup:
early sex with multiple partners


On the other hand, if she is classified as belonging into the at-risk group, most physicians would recommend a yearly Pap test until the Pap smear pattern is established. At his point the frequency might be lessened based on the cytology data. However, there is a high-risk subgroup of women who had sex very early in the teenage years with multiple partners, which puts them, as we will see below,into a high risk for papilloma related cervical lesions that can be precursors of cervical cancer.

Cancer of the cervix develops out of clusters of cancer cells (cancer in situ), which develop years before the invasive cervical cancer occurs. The peak for cancer in situ development is age 25 to 40. Invasive cancer of the cervix has a peak at the age of 48 to 55.

Every year in the U.S. 65,000 new cases of carcinoma in situ are diagnosed in women and every year 15,800 invasive cervical cancers are found as well. Every year 4,800 women die from invasive cervical cancer, which amounts to 2% of all cancer deaths in women or 18% of all gynecological cancers in women.

The sad part is: if all these women had gone for a yearly Pap test, almost none of them would have died!

 

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter on gynecological tumors.

2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter on gynecological tumors.

3. WG Quint et al. J Pathol 2001 May;194(1):51-58.

4. A Duenas-Gonzalez et al. Am J Clin Oncol 2001 Apr;24(2):201-203.

5. BD Kavanagh et al. Am J Clin Oncol 2001 Apr;24(2):113-119.

6. K Nakanishi et al. Skeletal Radiol 2001 Mar;30(3):132-137.

7. M Follen et al. Cancer 2001 May 1;91(9):1758-1776.

Last Modified: Feb. 2, 2012