Early diagnosis of cervical cancer is imperative for better prognosis. Because the early stages of cervical cancer are not associated with signs/symptoms, it is imperative that screening tests be used to catch early stages of cervical cancer. Women should begin screening for HPV infection and cervical cancer when they are 21 years of age. This age may vary depending on the patient’s risk factors, including their number of sexual partners and the age at which they began having sex.
The first screening test is the Pap smear. The pap smear is when the OB/GYN physician uses a speculum to visualize the cervix and then uses a medical instrument to brush or scrape some of the cells from the cervix. These cells are then sent to the laboratory and evaluated for any abnormalities. The pap smear will check for cancerous cells of the cervix. The next test is the HPV DNA test. This test checks for the actual HPV virus. The cells collected from the cervix will be evaluated for the HPV DNA. This test is done in women greater than the age of 30 or in patients who currently have, or who have a previous history of, an abnormal pap smear.
If the Pap smear and/or HPV DNA test comes back abnormal, the next step in diagnosis is through a colposcope evaluation. During this examination, the physician will likely take a biopsy to determine if cervical cancer is present. A biopsy can be in the form of a punch biopsy or an endocervical curettage. If these tests come back abnormal, then the next step is to perform either an electrical wire loop tissue sample or a cone biopsy, that will allow for better evaluation of the deeper layers of the cervix. The tissue will be evaluated at the laboratory to determine if cervical cancer is present.
Stages of Cervical Cancer:
In patients who have a positive biopsy for cervical cancer, the next step is to determine the stage of cancer. Staging is based on tumor size, nodal involvement, and metastases to other areas of the body. There are four stages of cervical cancer.
In patients who have a positive biopsy for cervical cancer, the next step is to determine the stage of cancer. Staging is based on tumor size, nodal involvement, and metastases to other areas of the body. There are four stages of cervical cancer.
Stage 0 is the least invasive and has the best prognosis, and Stage IV is the most invasive with the poorest prognosis.
Stage 0 is Carcinoma In Situ and is not invasive.
Stage I cervical cancer, the cancer is located only in the cervix.
Stage II means that the cancer is present in the cervix and the upper section of the vagina.
Stage III cervical cancer means that cancer has moved from the cervix and upper section of the vagina to the lower section of the vagina or internally to the pelvic side wall.
Stage IV cervical cancer means that there is involvement of other near organs such as the rectum or bladder. Stage IV can also mean the distant spread of cancer too (most commonly) liver, lungs and/or bone.
