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Cervical cancer: Difference between revisions
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<section begin="gyn1" /><section begin="CIN" />'''Cervical cancer''' is the cancer of the uterine cervix. It's the 4th most common cancer in females, but the 6th most common cause of cancer death. It mostly affects women 35 - 50 years old. It progresses from '''cervical intraepithelial neoplasia''' (CIN), which is the precancerous lesion of cervical cancer. Human papilloma virus (HPV) infection is the cause in virtually all cases. | <section begin="oncology" /><section begin="gyn1" /><section begin="CIN" />'''Cervical cancer''' is the cancer of the uterine cervix. It's the 4th most common cancer in females, but the 6th most common cause of cancer death. It mostly affects women 35 - 50 years old. It progresses from '''cervical intraepithelial neoplasia''' (CIN), which is the precancerous lesion of cervical cancer. Human papilloma virus (HPV) infection is the cause in virtually all cases. | ||
Cervical carcinoma is a “controllable”, highly preventable cancer for three reasons: | Cervical carcinoma is a “controllable”, highly preventable cancer for three reasons: | ||
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<section end="gyn1" /> | <section end="gyn1" /> | ||
=== Cervical intraepithelial neoplasia === | === Cervical intraepithelial neoplasia === | ||
CIN is the precancerous lesion of cervical cancer. According to severity, CIN is classified as CIN 1 to CIN 3, where CIN3 has the highest risk of malignancy. A significant number (possibly up to 70%) of CIN 2+ lesions regress over time rather than progress to cancer, and this number is even higher for CIN 1 lesions. However, as of yet we have no way of distinguishing lesions which will progress from those who will regress. As such, all CIN II+ lesions must be treated. | CIN is the precancerous lesion of cervical cancer. According to severity, CIN is classified as CIN 1 to CIN 3, where CIN3 has the highest risk of malignancy. A significant number (possibly up to 70%) of CIN 2+ lesions regress over time rather than progress to cancer, and this number is even higher for CIN 1 lesions. However, as of yet we have no way of distinguishing lesions which will progress from those who will regress. As such, all CIN II+ lesions must be treated. <section end="oncology" /> | ||
CIN 1 - 3 are histological diagnoses, which must be obtained by punch biopsy, conisation or other histological sample. CIN 1 is characterised by mild dysplasia and changes present in the lower third of the basal epithelium. CIN 2 is characterised by moderate dysplasia and changes present in the lower two thirds of the basal epithelium. CIN 3 is characterised by severe atypia or squamous carcinoma in situ and changes present in more than two thirds of the basal epithelium. By definition, the basal membrane is intact in CIN. If it is not, the diagnosis is invasive cervical cancer. We use the term “CIN 2+” to refer to any of CIN II, CIN III, or invasive cancer. | CIN 1 - 3 are histological diagnoses, which must be obtained by punch biopsy, conisation or other histological sample. CIN 1 is characterised by mild dysplasia and changes present in the lower third of the basal epithelium. CIN 2 is characterised by moderate dysplasia and changes present in the lower two thirds of the basal epithelium. CIN 3 is characterised by severe atypia or squamous carcinoma in situ and changes present in more than two thirds of the basal epithelium. By definition, the basal membrane is intact in CIN. If it is not, the diagnosis is invasive cervical cancer. We use the term “CIN 2+” to refer to any of CIN II, CIN III, or invasive cancer. | ||
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** Endocervical adenocarcinoma in situ (AIS) | ** Endocervical adenocarcinoma in situ (AIS) | ||
** Adenocarcinoma | ** Adenocarcinoma | ||
<section end="CIN" /><section begin="gyn1" /> | <section end="CIN" /><section begin="gyn1" /><section begin="oncology" /> | ||
== Clinical features == | == Clinical features == | ||
Early cervical cancer is frequently asymptomatic. The most common symptoms are: | Early cervical cancer is frequently asymptomatic. The most common symptoms are: | ||
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In Norway, this includes women at the age of 25 - 69, and involves screening every 5 years. The cytology specimen is first analysed for HPV. If there is no HPV, the cytology specimen is not examined. If there is HPV, the specimen is examined for CIN. If there are signs of CIN or HPV positivity, more frequent screenings or colposcopy and biopsy are recommended, depending on the type of CIN and HPV. | In Norway, this includes women at the age of 25 - 69, and involves screening every 5 years. The cytology specimen is first analysed for HPV. If there is no HPV, the cytology specimen is not examined. If there is HPV, the specimen is examined for CIN. If there are signs of CIN or HPV positivity, more frequent screenings or colposcopy and biopsy are recommended, depending on the type of CIN and HPV. | ||
In Hungary, screening with Pap smear is recommended once a year in sexually active women of all ages. If older than 65, screening is recommended every two years.<section end="CIN" /> | In Hungary, screening with Pap smear is recommended once a year in sexually active women of all ages. If older than 65, screening is recommended every two years.<section end="CIN" /><section end="oncology" /> | ||
[[Category:Gynaecology]] | [[Category:Gynaecology]] | ||
[[Category:Oncology]] | [[Category:Oncology]] | ||