Tuesday, August 5, 2025

Here is a complete overview of Carcinoma of the Cervix (Cervical Cancer)—a common and preventable cancer affecting women, especially in developing countries.


๐Ÿงฌ CERVICAL CANCER (Ca Cervix): Complete Details


๐Ÿ”น Definition

Cervical cancer is a malignant tumor arising from the cells of the cervix, which is the lower part of the uterus that connects to the vagina.


๐Ÿ”น Types of Cervical Cancer

  1. Squamous Cell Carcinoma (≈ 70–80%)

    • Arises from the squamous epithelial lining.

  2. Adenocarcinoma (≈ 10–15%)

    • Arises from glandular (columnar) epithelium.

  3. Adenosquamous carcinoma

    • A mix of both squamous and glandular cells.

  4. Rare types: Small cell carcinoma, neuroendocrine carcinoma


๐Ÿ”น Causes & Risk Factors

Most cervical cancers are caused by persistent infection with high-risk Human Papillomavirus (HPV) types, especially:

  • HPV 16 (most common)

  • HPV 18

Other risk factors:

  • Early onset of sexual activity

  • Multiple sexual partners

  • Immunosuppression (e.g., HIV)

  • Smoking

  • Long-term oral contraceptive use

  • Poor genital hygiene

  • Low socioeconomic status

  • Lack of regular Pap smear screening


๐Ÿ”น Symptoms

Early stages are usually asymptomatic.

Common symptoms (as disease progresses):

  • Abnormal vaginal bleeding (post-coital, intermenstrual, postmenopausal)

  • Foul-smelling vaginal discharge

  • Pelvic pain

  • Pain during intercourse (dyspareunia)

  • Leg swelling (due to lymphatic blockage)

  • Hematuria or rectal bleeding in advanced disease


๐Ÿ”น Screening & Early Detection

  1. Pap Smear (Papanicolaou test)

    • Detects precancerous changes (CIN – Cervical Intraepithelial Neoplasia).

  2. HPV DNA testing

    • Identifies high-risk HPV infections.

  3. Visual Inspection with Acetic Acid (VIA)

    • Low-cost screening tool in low-resource settings.

  4. Colposcopy

    • For visual inspection and biopsy.

WHO recommendation: Begin screening from age 25 or 30; every 3–5 years.


๐Ÿ”น Diagnosis

  • Pelvic examination

  • Pap smear results (e.g., LSIL, HSIL, ASCUS)

  • Colposcopy-guided biopsy

  • Endocervical curettage (ECC)

  • Imaging for staging:

    • MRI (best for local extent)

    • CT or PET-CT (for nodal and distant spread)


๐Ÿ”น Staging (FIGO 2018)

  • Stage I – Cancer confined to the cervix

  • Stage II – Beyond cervix but not to pelvic wall or lower third of vagina

  • Stage III – Involves pelvic wall or lower third of vagina; or causes hydronephrosis

  • Stage IV – Involves bladder, rectum, or distant organs


๐Ÿ”น Treatment

๐Ÿ’‰ Early stage (IA–IB1):

  • Surgery:

    • Conization (IA1)

    • Total or radical hysterectomy

    • Pelvic lymph node dissection

๐Ÿ”ฅ Locally advanced (IB2–IVA):

  • Concurrent chemoradiation

    • External Beam Radiation Therapy (EBRT)

    • Brachytherapy

    • Cisplatin-based chemotherapy

๐ŸŒ Advanced stage (IVB or recurrent):

  • Palliative chemotherapy

  • Targeted therapy (e.g., bevacizumab)

  • Immunotherapy (e.g., pembrolizumab in PD-L1 positive tumors)


๐Ÿ”น Prevention

Primary Prevention:

  • HPV Vaccination (Cervarix, Gardasil, Gardasil 9)

    • Recommended for girls and boys aged 9–14 years (before sexual debut)

    • Catch-up vaccination up to age 26 (sometimes up to 45)

Secondary Prevention:

  • Regular screening and early treatment of precancerous lesions

Tertiary Prevention:

  • Early diagnosis and proper cancer treatment


๐Ÿ”น Prognosis

Depends on stage at diagnosis:

  • 5-year survival rates:

    • Stage I: >90%

    • Stage II: ~70–80%

    • Stage III: ~50%

    • Stage IV: <30%


๐Ÿ”น Key Public Health Messages

  • Regular Pap/HPV screening saves lives.

  • HPV vaccination is a powerful preventive tool.

  • Educate women about early symptoms and encourage routine gynecological check-ups.


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