Cervical cancer overview: Difference between revisions

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==Treatment==
==Treatment==
===Primary Prevention===
===Primary Prevention===
Prevention of cervical cancer includes a comprehensive approach involving awareness, screening, and usage of preventative vaccinations.
Prevention of cervical cancer includes a comprehensive approach involving awareness, screening, and preventative vaccinations.
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 18:26, 25 August 2015

Cervical cancer Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cervical Cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

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CT

MRI

Ultrasound

Other Diagnostic Studies

Treatment

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Cervical Cancer During Pregnancy

Primary Prevention

Secondary Prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [5]

Overview

Cervical cancer is a malignant cancer of the cervix. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stages, which has made cervical cancer the focus of intense screening efforts using the Pap smear. In developed countries, the widespread use of cervical screening programs has reduced the incidence of invasive cervical cancer by 50% or more. Most scientific studies have found that human papillomavirus (HPV) infection is responsible for virtually all cases of cervical cancer.[1][2] Treatment consists of surgery (including local excision) in early stages and chemotherapy and radiotherapy in advanced stages of the disease. An effective HPV vaccine against the two most common cancer-causing strains of HPV has recently been licensed in the U.S. (see Vaccine section, below). These two HPV strains together are responsible for approximately 70%[3][4] of all cervical cancers. Experts recommend that women combine the benefits of both programs by seeking regular Pap smear screening, even after vaccination.

Historical Perspective

Cervical cancer was first described in 400 BC. In 1928, the Papanicolaou technique was developed by Papanicolaou to diagnose cervical cancer. In 1976, Harald zur Hausen and Gisam were the first to discover the association between HPV and development of cervical cancer.

Classification

Cervical cancer may be classified into many subtypes based on WHO histological classification.

Pathophysiology

Cervical cancer arises at squamous-columnar junction.

Differential diagnosis

Cervical cancer must be differentiated from other diseases that cause abnormal vaginal bleeding, such as cervical polyp, cervical leiomyoma, invasion of the cervix from primary uterine malignancy, vaginal cancer, cervical lymphoma, adenoma malignum, metastases to cervix, and cervical ectopic pregnancy.

Epidemiology and Demographics

Worldwide, cervical cancer is the third most common cancer among women and the second most frequent cause of cancer-related death, accounting for nearly 300,000 deaths annually.[1] In developing nations, it is often the most common cause of cancer-related death among women and a leading cause of death overall.[1] Once one of the most common cancers affecting U.S. women, cervical cancer now ranks 14th in frequency.[1] Because precancerous lesions found by Pap smears can be treated and cured before they develop into cancer, and because cervical cancer is often detected before it becomes advanced, the incidence and death rates for this disease are relatively low.[1] According to the most recent data, the age-adjusted incidence rate for cervical cancer was 6.73 cases per 100,000 women in the United States in 2011.

Risk Factors

The most potent risk factor in the development of cervical cancer is Human papillomavirus (HPV) infection. Other risk factors include smoking, increased number of sexual partners, and young age at time of first sexual intercourse.

Screening

According to the American Cancer Society (ACS), American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology, screening for cervical cancer by pap smear is recommended every 3 years among women age 21.

Natural History, Complications and Prognosis

If left untreated, 30-70% of patients with in situ cervical cancer may progress to develop cervical cancer. Common complications of cervical cancer include vaginal bleeding, fistula and renal failure. Prognosis is generally good, and the 5 year survival rate of patients with cervical cancer is approximately 67.9%.

Diagnosis

Staging

Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, rather than surgical findings. It allows only the following diagnostic tests to be used in determining the stage: palpation, inspection, colposcopy, endocervicalcurettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, and X-ray examination of the lungs and skeleton, and cervicalconization.

History and Symptoms

Physical examination of patients with late cervical cancer is usually remarkable fore cervical mass, pallor, and pedal edema.

Other Diagnostic Studies

Cervical biopsy is the confirmatory test for the diagnosis of cervical cancer or pre-cancer.

Treatment

Primary Prevention

Prevention of cervical cancer includes a comprehensive approach involving awareness, screening, and preventative vaccinations.

References

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