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Cervical Cancer
I.
II.
III.
IV.
V.
VI.
Cervical dysplasia
Cervical cancer
Causes
Risk factors
Detection: Pap Smear & Colposcopy
Treatment
Cervical Cancer Overview

Cervical cancer develops in the lining of the
cervix and this condition usually develops
over time.
I. Cervical dysplasia = abnormal tissue growth

Remain within the
cervical tissue, easy to
treat

High-grade dysplasia =
II. From cervical dysplasia to cancer
A.
Cancerous condition usually develops over
time.


Normal cervical cells may gradually undergo
changes to become precancerous and then
cancerous
Cervical intraepithelial neoplasia (CIN) is the
term used to describe these abnormal changes.

CIN is classified according to the degree of cell
abnormality. Low-grade CIN indicates a minimal
change in the cells and high-grade CIN indicates
Most (80-90%) invasive cervical cancer develops in flat, scaly surface cells that
line the cervix
Approximately 10-15% of cases develop in glandular surface cells
B. Incidence & Prevelance

Cervical cancer is the 2nd most common
cancer in women worldwide and is a leading
cause of cancer-related death in women in
underdeveloped countries.

!
III. What causes cervical cancer?

HPV strains found most frequently in
precancerous lesions and in cervical cancer are
types 16 and 18. Other strains with high malignant
potential include 31, 33, 35, 39, 45, 51, 52, 56, 58,
and 68.
A. HPV – carries oncogenes

It is proposed that HPV interferes with p53 & pRB
http://www-ermm.cbcu.cam.ac.uk/swf003mac.swf
B. Risk factors

1)
2)
3)
4)
The risk of developing cervical cancer is directly
associated with the risk of contracting HPV
Having multiple sexual partners or having sex with
a promiscuous partner
History of sexually transmitted disease (STD)
Sexual intercourse at a young age – hormonal
shifts that occur w/adolescence appear to make
the cervical cells more susceptible to infection with
HPV
Smoking decreases the ability of the immune
system and women who smoke have a higher
incidence of cervical cancer
IV. Symptoms

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Abnormal vaginal bleeding (e.g., spotting
after sexual intercourse, bleeding between
menstrual periods, increased menstrual
bleeding)
Abnormal (yellow, odorous) vaginal discharge
Low back pain
Painful sexual intercourse (dyspareunia)
Painful urination (dysuria)
V. Detection
A.
PAP smear

B.
C.
Fluid-based test allows for
the separation of cervical
cells for more accurate
examination
DNA testing of
Colposcopy –
VI. Treatment
A.

1)
2)
3)
4)
For cervical dysplasia
In its earliest stages precancerous tissue can be
removed
Cryotherapy
Loop electrosurgical
excision procedure
(LEEP)
Laser surgery
Cone biopsy
B. Treatment for cervical cancer


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Because the cells can spread, more extensive
treatment necessary.
Treatment depends on the stage, the size and
shape of the tumor, the age and general health of
the woman, and her desire for future childbearing.
Radical hysterectomy prescribed for more advanced
stages
Radiation or chemotherapy may be used to treat
cancer that has spread beyond the pelvis, or has
recurred
C. Cure rate – early detection, 85%
80 - 85% for tumors limited to the cervix and
uterus
60 - 80% when the upper part of the vagina is
involved
30 - 50% for tumors beyond the cervix and
upper vagina, but still in the pelvis
14% when the cancer has invaded the
bladder or rectum or has spread beyond the
pelvis
 Race & Poverty is an issue
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
ACS info site
http://www.cancer.org/docroot/CRI/CRI_2_1x.
asp?dt=8
Institute of Human Virology site
http://www.ihv.org/guides/cervical_cancer.htm
l
Vaccine!!!
“Cervical cancer prevented in 2-year study
Experimental vaccine shows promise in
halting early stages of disease” – Chronicle
 The new vaccine prevents cervical cancer
by blocking certain strains of HPV.
 Merck & Co., the vaccine targets two strains
of HPV that are known to cause at least 70%
of cervical cancers, and two other strains
that cause genital warts.