1. Cervical Cancer
By: Patricia Montoya

2. Cervix
 Lower part of the uterus
 Connects the body of the
uterus to the vagina (birth
canal)
Source: American Cancer Society

3. Cervical Cancer
 Begins in the lining of the cervix
 Cells change from normal to pre-cancer
(dysplasia) and then to cancer
Source: American Cancer Society

4. Three Types
 Squamous cell Carcinomas
– Cancer of flat epithelial cell
– 80% to 90%
 Adenocarcinomas
– Cancer arising from glandular epithelium
– 10% - 20%
 Mixed carcinoma
– Features both types
Source: American Cancer Society

5. Statistics
 10,520 new cases in the U.S. this year
 3,900 will die
 50% are diagnosed between ages 35 and 55.
 20% at the age of 65 or over.
 Rarely occurs in women younger than 20
 Noninvasive is four times more common
 74% decrease in deaths between 1955 and
1992 in the U.S.
 Death rate continuous to decline by 2% a year
Source: American Cancer Society

6. Lifetime Probability of Developing Cancer, by
Site, Women, US, 1998-2000
Site Risk
All sites 1 in 3
Breast 1 in 7
Lung & bronchus 1 in 17
Colon & rectum 1 in 18
Uterine corpus 1 in 38
Non-Hodgkin lymphoma 1 in 57
Ovary 1 in 59
Pancreas 1 in 83
Melanoma 1 in 82
Urinary bladder 1 in 91
Uterine cervix 1 in 128
Source:DevCan: Probability of Developing or Dying of Cancer Software, Version 5.1 Statistical Research and
Applications Branch, NCI, 2003. http://srab.cancer.gov/devcan

7. Signs and Symptoms
 Vaginal bleeding
 Menstrual bleeding is longer and heavier than usual
 Bleeding after menopause or increased vaginal
discharge
 Bleeding following intercourse or pelvic exam
 Pain during intercourse
Source: American Cancer Society

8. Risk Factors
 Human papillomavirus infection (HPV) – Primary factor
– HPV 16, HPV 18, HPV 31, HPV 33, HPV 45
– 50% are caused by HPV 16 AND 18
 Sexual behavior
 Smoking
 HIV infection
 Chlamydia infection
 Diet
 Oral contraceptives
 Multiple pregnancies
 Low socioeconomic status
 Diethylstilbestrol (DES)
 Family history
Source: American Cancer Society

9. Prevention
 Avoiding the risk factors
– Especially HPV
– Help for low-income women (NBCCEDP)
 Having the Pap Test
– 3 years after first vaginal intercourse or by age 21.
– Have test annually
Source: American Cancer Society

10. Diagnosis
 Cervical Cytology (Pap Test)
– Cells are removed from the cervix and
examined under the microscope.
– Can detect epithelial cell abnormalities
 Atypical squamous cells
 Squamous intraepithelial lesions
 Squamous cell carcinoma (likely to be invasive)
Source: American Cancer Society

11. Diagnosis
 Additional testing
– Colposcopy
 Cervix is viewed through a colposcope and the
surface of the cervix can be seen close and clear.
– Cervical Biopsies
 Colposcopic biopsy – removal of small section of
the abnormal area of the surface.
 Endocervical curettage – removing some tissue
lining from the endocervical canal.
 Cone biopsy – cone-shaped piece of tissue is
removed from the cervix

12. Staging
 FIGO System (International Federation Of Gynecology and Obstetrics)
 Has five stages – 0 to 4
– Stage 0 Carcinoma in situ
– Stage 1 Invaded cervix, but has not spread.
– Stage 2 Has spread to nearby areas, not leaving pelvic area.
– Stage 3 Cancer has spread to the lower part of the vagina.
– Stage 4 Cancer has spread to nearby organs; metastasis.
Source: American Cancer Society

13. Survival Rate
 5-year survival rate is 92% for earliest stage
 71% for all stages combined
Source: American Cancer Society

14. Treatment
 Surgery
– Preinvasive cervical cancer
 Cryosurgery
 Laser surgery
 Conization
– Invasive cervical cancer
 Simple hysterectomy
– Removal of the body of the uterus and cervix.
 Radical hysterectomy and pelvic lymph node dissection
– Removal of entire uterus, surrounding tissue, upper part
of the vagina, and lymph nodes from the cervix.
 Radiation
 Chemotherapy

15. What’s new in cervical cancer
research and treatment?
 HPV test
 HPV vaccine
 Radical trachelectomy procedure
 Other clinical trials
Source: American Cancer Society