There will be approximately 82,000 new cases of gynecologic malignancies in the year 2000. Cervical cancer is the third most common gynecologic malignancy and the eighth most common malignancy among women in the United States. There will be almost 14,000 women in the United States diagnosed with invasive cancer each year. Nearly, 5,000 women will die of this disease in the year 2000. The recent results of many prospective, randomized studies (trials) conclude that the appropriate use of surgery, radiation and/or chemotherapy, have led to improved survival rates in women with cervical carcinoma.
The average age for developing cervical cancer is about 50;however, it can effect women as young as 20 years old. When discovered and treated early, cervical cancer can be cured. The American Cancer Society states that cervical cancer used to be one of the most common causes of cancer death for American women. Between 1955 and 1992 the number of deaths from cervical cancer declined by 74%. The primary reason for this change is the use of the Pap test to find early cancer.
The Pap Test is simple and painless. The best time for a Pap test is when a woman is not menstruating, between 10 and 20 days after the first day of her period. For two days before the Pap test, a women should avoid douching or using spermicidal foams, creams and jellies, or vulvar medicines (except as directed by a doctor), which may wash away for hide abnormal cells.
What is Cervical Cancer?
Cancer of the cervix is a disease in which malignant cells are found in the tissues of the cervix (see diagram). The uterus is a hollow, pear shaped organ where a baby develops. The cervix connects the uterus to the vagina (birth canal).
First, some cells begin to change from normal to pre-cancerous (dysplasia non-invasive) and then cancer (invasive). Most cervical cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that form the surface of the cervix. Normally, cells divide to produce more cells only when the body needs them. This process helps keep us healthy. If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of extra tissue, called a growth or tumor can be benign or malignant.
Cancer of the cervix usually grows slowly over a long period of time. Before cancer cells are found on the cervix, the tissue of the cervix goes through changes in which cells that are not normal begin to appear. The precursor cells (cervical intraepithelial neoplasia, CIN, dysplasia) may develop into invasive cervical cancer, and usually this process takes a number of years. CIN grades 1,2 and 3 correspond to mild, moderate and severe cervical dysplasia. CIN-3, (also terminal severe dysplasia and carcinoma in situ) is unlikely to spontaneously and, if untreated, may eventually becoming cancer.
The most common cell type of cervical cancer is squamous cell carcinoma and this accounts for 80-85% of all cervical cancers; adenocarcinoma account for most of the rest.
Invasive cervical cancer may spread by direct extension into surrounding tissues and the vagina or via the lymphatic to the pelvic and paraaortic lymph nodes drained by the cervix.
