1. Cervical CancerCervical Cancer
By: Patricia MontoyaBy: Patricia Montoya

2. CervixCervix
 Lower part of the uterusLower part of the uterus
 Connects the body of theConnects the body of the
uterus to the vagina (birthuterus to the vagina (birth
canal)canal)
Source: American Cancer SocietySource: American Cancer Society

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

4. Three TypesThree Types
 Squamous cell CarcinomasSquamous cell Carcinomas
– Cancer of flat epithelial cellCancer of flat epithelial cell
– 80% to 90%80% to 90%
 AdenocarcinomasAdenocarcinomas
– Cancer arising from glandular epitheliumCancer arising from glandular epithelium
– 10% - 20%10% - 20%
 Mixed carcinomaMixed carcinoma
– Features both typesFeatures both types
Source: American Cancer SocietySource: American Cancer Society

5. StatisticsStatistics
 10,52010,520 new cases in the U.S. this yearnew cases in the U.S. this year
 3,9003,900 will diewill die
 50%50% are diagnosed between ages 35 and 55.are diagnosed between ages 35 and 55.
 20%20% at the age of 65 or over.at the age of 65 or over.
 Rarely occurs in women younger than 20Rarely occurs in women younger than 20
 Noninvasive is four times more commonNoninvasive is four times more common
 74%74% decrease in deaths between 1955 anddecrease in deaths between 1955 and
1992 in the U.S.1992 in the U.S.
 Death rate continuous to decline byDeath rate continuous to decline by 2%2% a yeara year
Source: American Cancer SocietySource: American Cancer Society

6. Lifetime Probability of Developing Cancer, byLifetime Probability of Developing Cancer, by
Site, Women, US, 1998-2000Site, 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 SymptomsSigns and Symptoms
 Vaginal bleedingVaginal bleeding
 Menstrual bleeding is longer and heavier than usualMenstrual bleeding is longer and heavier than usual
 Bleeding after menopause or increased vaginalBleeding after menopause or increased vaginal
dischargedischarge
 Bleeding following intercourse or pelvic examBleeding following intercourse or pelvic exam
 Pain during intercoursePain during intercourse
Source: American Cancer SocietySource: American Cancer Society

8. Risk FactorsRisk Factors
 Human papillomavirus infection (HPV) – Primary factorHuman papillomavirus infection (HPV) – Primary factor
– HPV 16, HPV 18, HPV 31, HPV 33, HPV 45HPV 16, HPV 18, HPV 31, HPV 33, HPV 45
– 50% are caused by HPV 16 AND 1850% are caused by HPV 16 AND 18
 Sexual behaviorSexual behavior
 SmokingSmoking
 HIV infectionHIV infection
 Chlamydia infectionChlamydia infection
 DietDiet
 Oral contraceptivesOral contraceptives
 Multiple pregnanciesMultiple pregnancies
 Low socioeconomic statusLow socioeconomic status
 Diethylstilbestrol (DES)Diethylstilbestrol (DES)
 Family historyFamily history
Source: American Cancer SocietySource: American Cancer Society

9. PreventionPrevention
 Avoiding the risk factorsAvoiding the risk factors
– Especially HPVEspecially HPV
– Help for low-income women (NBCCEDP)Help for low-income women (NBCCEDP)
 Having the Pap TestHaving the Pap Test
– 3 years after first vaginal intercourse or by age 21.3 years after first vaginal intercourse or by age 21.
– Have test annuallyHave test annually
Source: American Cancer SocietySource: American Cancer Society

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

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

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

13. Survival RateSurvival Rate
 5-year survival rate is 92% for earliest stage5-year survival rate is 92% for earliest stage
 71% for all stages combined71% for all stages combined
Source: American Cancer SocietySource: American Cancer Society

14. TreatmentTreatment
 SurgerySurgery
– Preinvasive cervical cancerPreinvasive cervical cancer
 CryosurgeryCryosurgery
 Laser surgeryLaser surgery
 ConizationConization
– Invasive cervical cancerInvasive cervical cancer
 Simple hysterectomySimple hysterectomy
– Removal of the body of the uterus and cervix.Removal of the body of the uterus and cervix.
 Radical hysterectomy and pelvic lymph node dissectionRadical hysterectomy and pelvic lymph node dissection
– Removal of entire uterus, surrounding tissue, upper partRemoval of entire uterus, surrounding tissue, upper part
of the vagina, and lymph nodes from the cervix.of the vagina, and lymph nodes from the cervix.
 RadiationRadiation
 ChemotherapyChemotherapy

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