Cervical cancer is a type of cancer that occurs in the cervix, which is the lower part of the uterus that connects to the vagina. It is caused by the human papillomavirus (HPV), which is a sexually transmitted infection. Cervical cancer typically develops slowly over time and can be detected and treated in its early stages through regular cervical cancer screenings. Symptoms of cervical cancer can include: Vaginal bleeding, including between periods, after sexual intercourse, or after menopause Vaginal discharge that is unusual in color, consistency, or smell Pain during sexual intercourse Pelvic pain Risk factors for cervical cancer include: HPV infection Smoking Weak immune system Long-term use of oral contraceptives Multiple pregnancies High-risk sexual behavior HIV infection The most effective way to prevent cervical cancer is through regular cervical cancer screenings, such as Pap tests and HPV tests. These tests can detect abnormal cells in the cervix before they become cancerous. If cervical cancer is diagnosed, treatment options can include surgery, radiation therapy, and chemotherapy. The choice of treatment will depend on the stage of the cancer and the overall health of the patient. It's important to note that cervical cancer is preventable and that regular cervical cancer screenings can detect abnormal cells early, before they become cancerous. Additionally, HPV vaccination can protect against the types of HPV that cause most cervical cancers.

1. Cervical Cancer

2. Introduction
most common gynecological cancer in developing countries
Decreased in the developed countries due to screening and vaccination
Risk factors : HPV, Smoking ,multiparity, use of COC , early sexual intercourse, multiple sexual
partners
High risk types of HPV is the most common risk factor , present in 99.7 % of the cases with HPV
16 , 18 responsible for 70 % of cases

3. Clinical presentation
Asymptomatic : incidental finding during screening
AUB : postcoital bleeding , intermenstrual , HMB and PMB
Symptoms of metastasis : genitourinary fistula , renal failure , anemia , neurological symptoms

4. Histopathology
2 types : squamous cell carcinoma or adenocarcinoma
70 % of cases (most common ) are squamous cell carcinoma, predisposed by HPV 16 and CIN
30 % of cases are adenocarcinoma , predisposed by HPV 18 and CGIN (glandular premalignant
lesion )
Spread : most commonly local infiltration of the pelvis

5. Staging (FIGO)
Staged CLINICALLY by :
Biopsy
MRI
CXR or CT chest
Urogram, cystoscopy
Lower GI endoscopy

7. Treatment
Stage 1A : conization or simple hysterectomy
Stage 1A2 and 1B (small IB ) 3 options :
A. THE STARNDARD : radical hysterectomy and bilateral pelvic node dissection (Wertheim’s
hysterectomy)
B. If fertility sparing : radical trachelectomy and bilateral pelvic node dissection
C. If surgically unfit : radiotherapy
Stage II- IV : RADIOTHERAPY (beyond the cervix )

8. Cervical conization

9. Radical trachelectomy

10. Hysterectomy