Cervical cancer develops from cells in the cervix as a result of human papillomavirus (HPV) infection in some cases. There are two main types of cervical cancer - squamous cell carcinoma and adenocarcinoma - which differ in their origin cell type. Risk factors include multiple sexual partners, early sexual activity, other sexually transmitted infections, a weakened immune system, and smoking. Early stage cervical cancers may be asymptomatic, but can eventually cause abnormal bleeding or discharge. Screening tests include the Pap test and HPV DNA test to detect abnormal or cancerous cells. Diagnosis involves examination, biopsy, and determining the cancer stage. Treatment options are surgery, radiation therapy, chemotherapy, or a combination, depending on

2. Cervical cancer is a type of cancer that
occurs in the cells of the cervix — the lower
part of the uterus that connects to the vagina.
Various strains of the human papillomavirus
(HPV), a sexually transmitted infection, plays
a role in causing most cases of cervical
cancer.
When exposed to HPV, a woman's immune
system typically prevents the virus from
doing harm. In a small group of women,
however, the virus survives for years,
contributing to the process that causes some
cells on the surface of the cervix to become
cancer cells.
DEFINITION

3. • SQUAMOUS CELL CARCINOMA- These begin in the thin, flat cells
(squamous cells) that line the outer portion of the cervix, which
projects into the vagina. This type accounts for the great majority of
cervical cancers. About 80% to 90% of cervical cancers are squamous
cell carcinomas.
• ADENOCARCINOMA – These seem to have become more common
in the past 20 to 30 years. Cervical adenocarcinoma develops from the
mucus-producing gland cells of the endocervix.
• Less commonly, cervical cancers have features of both squamous cell
carcinoma and adenocarcinoma. These are called
ADENOSQUAMOUS CARCINOMAS or mixed carcinomas.
TYPES OF CERVICAL
CANCER

4. TYPES OF CERVICAL
CANCER

5. What causes cervical cancer isn't clear. However, it's certain that
the sexually transmitted infection called Human Papillomavirus (HPV)
plays a role. HPV can cause normal cells on your cervix to turn
abnormal. Over many years, abnormal cells can turn into cancer if they
are not found and treated by your doctor. It can take 10 to 15 years (or
more) for cells to change from normal to abnormal, and then into
cancer. Abnormal cells are sometimes called “precancerous” because they
are not normal, but they are not yet cancer.
While HPV is a very common virus, most women with HPV
never develop cervical cancer. This means other risk factors such as your
genetic makeup, your environment or your lifestyle choices also
determine whether you'll develop cervical cancer.
CAUSE

6. These factors may increase your risk of cervical cancer:
• Many sexual partners - The greater your number of sexual partners and the greater
your partner's number of sexual partners the greater your chance of acquiring HPV.
• Early sexual activity - Having sex at an early age increases your risk of HPV.
• Other sexually transmitted infections (STIs) - If you have other STIs such as
chlamydia, gonorrhea, syphilis or HIV/AIDS, you have an increased risk of having
HPV.
• A weak immune system - Most women who are infected with HPV never develop
cervical cancer. However, if you have an HPV infection and your immune system is
weakened by another health condition, you may be more likely to develop cervical
cancer.
• Cigarette smoking - Smoking and an HPV infection may work together to cause
cervical cancer.
RISK FACTORS

7. TYPES OF HPV

8. Early cervical cancers usually don’t cause symptoms. When the cancer grows larger,
women may notice abnormal vaginal bleeding:
• Bleeding that occurs between regular menstrual periods
• Bleeding after sexual intercourse or a pelvic exam
• Menstrual periods that last longer and are heavier than before
• Bleeding after going through menopause
Women may also notice…
• Increased vaginal discharge
• Pelvic pain
• Pain during sex
Cervical cancer, infections, or other health problems may also cause these symptoms. A
woman with any of these symptoms should tell her doctor so that problems can be
diagnosed and treated as early as possible.
SYMPTOMS

9. When cervical cancer is detected in its earliest stages, treatment is more likely to be
successful. Most guidelines suggest beginning screening for cervical cancer and
precancerous changes at age 21. Screening for cervical cancer includes:
Pap Test - During a Pap test, your doctor scrapes and brushes cells from the cervix
and sends the sample to a lab to be examined for abnormalities. A Pap test can
detect abnormal cells in the cervix, including cancer cells and cells that show
changes (dysplasia) that increase the risk of cervical cancer.
HPV DNA Test - If you are age 30 or older, your doctor may also use a lab test
called the HPV DNA Test to determine whether you are infected with any of the
types of HPV that are most likely to lead to cervical cancer. Like the Pap test, the
HPV DNA Test involves collecting cells from the cervix for lab testing.
TESTS

10. If you experience signs and symptoms of cervical cancer or if a Pap test has
revealed cancerous cells, you may undergo further tests to diagnose your cancer.
To make a diagnosis, your doctor may:
Examine your cervix - During an exam called colposcopy, your doctor uses a
special magnifying instrument (colposcope) to examine your cervix for
abnormal cells. If your doctor identifies unusual areas, he or she may take a
small sample of cells for analysis.
Take a sample of cervical cells - During a biopsy procedure, your doctor
removes a sample of unusual cells from your cervix using special biopsy tools.
DIAGNOSIS

11. A Cone Biopsy (Conization) - So called because it involves taking a cone-shaped
sample of the cervix; it allows your doctor to obtain deeper layers of cervical cells for
laboratory testing. Your doctor may use a scalpel, laser or electrified wire loop to
remove the tissue.
Punch Biopsy - The doctor uses a sharp tool to pinch off small samples of cervical
tissues.
LEEP - The doctor uses an electric wire loop to slice off a thin, round piece of
cervical tissue.
Endocervical Curettage - The doctor uses a curette to scrape a small sample of tissue
from the cervical canal. Some doctors may use a thin, soft brush instead of a curette.
DIAGNOSIS

12. Stage I: Cancer cells are found only in the cervix.
Stage II: The tumor has grown through the cervix and invaded the upper part
of the vagina. It may have invaded other nearby tissues but not the pelvic wall
or the lower part of the vagina.
Stage III: Cancer at this stage has moved beyond the cervix to the pelvic side
wall or the lower portion of the vagina.
Stage IV: The tumor has invaded the bladder or rectum. Or, the cancer has
spread to other parts of the body, such as the lungs.
STAGING

13. Treatment for cervical cancer depends on several factors, such as the stage of
the cancer, other health problems you may have and your preferences about
treatment. Treatment options may include:
Surgery - Surgery to remove the uterus (hysterectomy) is typically used to treat
the early stages of cervical cancer.
Simple Hysterectomy: Involves the removal of the cancer, the cervix and the
uterus. A simple hysterectomy is typically an option only when the cancer is at a
very early stage — invasion is less than 3 mm into the cervix.
Radical Hysterectomy: Is the removal of the cervix, uterus, part of the vagina
and lymph nodes in the area and it is the standard surgical treatment when
there's invasion greater than 3 mm into the cervix.
TREATMENT

14. Radiation - Radiation therapy uses high-powered energy to kill cancer cells. Radiation
therapy can be given externally using external beam radiation or internally
(brachytherapy) by placing devices filled with radioactive material near your cervix.
Both methods of radiation therapy can be combined. Radiation therapy can be used
alone, with chemotherapy, before surgery to shrink a tumor or after surgery to kill any
remaining cancer cells. Premenopausal women may stop menstruating as a result of
radiation therapy and begin menopause.
Chemotherapy - Chemotherapy uses drugs to kill cancer cells. Chemotherapy drugs,
which can be used alone or in combination with each other, are usually injected into a
vein, and they travel throughout your body killing rapidly growing cells, including
cancer cells. Low doses of chemotherapy are often combined with radiation therapy,
since chemotherapy may enhance the effects of the radiation. Higher doses of
chemotherapy are used to control advanced cervical cancer that may not be curable.
Certain chemotherapy drugs may cause infertility and early menopause in
premenopausal women.
TREATMENT