Epidemiology

• Cervical cancer is the 2nd most common cancer in the women worldwide

• Rare before 20yrs ,,, mean age is 47yrs

Factors associated with high risk

Multiple sexual partners

Human papillomavirus(HPV)

Infection with HPV is one of the major factors leading to CC

Type 16 and 18

Type 6

and 11

Pathophysiology

Pathophysiology

The area between the original SCJ and

the new SCJ

Is called the transformation

zone(ectropion)

Cervical Intraepithelial Metaplasia

3 grades --> depending on the degree of cytological atypia thickness of the epi involved

Cervical Intraepithelial Metaplasia (CIN)

Screening and Cytology

Pap smear Conventional smear Liquid Based smear

Colposcopy

Treatment of CIN

Observation mild dysplasia (CIN I) may regress

spontaneously

Active treatment higher grades CIN II / CIN III

Invasive CancerPathological features2 main types Squamous cell carcinoma --> most

cases Adenocarcinoma --> 15 – 20%

Most occur at the SCJ

Melanoma and sarcoma occur rarely

Invasive CancerPatterns of spread

Invasive CancerStaging

Cervical cancer is the only gynecological malignancy that is

not surgically staged

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