Cervical cancer

• Cervical cancer is the most common gynecologic cancer in women

• The cervix is the lower, narrow end of the uterus. The cervix connects
the vagina (birth canal) to the upper part of the uterus.
• Cervical cancer occurs when abnormal cells on the cervix grow out of
control
 ETIOLOGY
• Infection with the virus called HPV (Human Papillomavirus) is the
cause of almost all cervical cancer
• The majority HPV infection can be transmitted via sexual contact. But
HPV infection can be transmitted also via nonsexual routes
• There are many types of HPV. Some HPV types can cause change on
woman’s cervix than can lead to cervical cancer, and the other type
can cause genital or skin warts
 EPIDEMIOLOGY
• Cervical cancer is the third most common malignancy in women
worldwide
• The frequency varies considerably between developed and
developing countries
• In 2006, The American Cancer Society estimated 9.710 new cases and
3.700 deaths from cervical cancer
• In 2013, an estimated 98.692 cases were indentified in Indonesia
 RISK FACTORS
• Having several sexual partners
• Having given birth to three or more children
• Smoking
 SIGNS AND SYMPTOMS
Most early cancers are asymptomatic, whereas symptoms of advancing
cervical cancer may include :
• Abnormal bleeding
• Increased vaginal discharge
• Pelvic pain
• Pain during sex
 EXAMINATION
• For many years, the Pap test has been the standard method for cervical
cancer screening. Retrospective data have shown that screening with a Pap
test reduces the incidence of cervical cancer by 60-90% and the death rate
by 90%.
• A Pap test is a test of a sample of cells taken from a woman's cervix or
vagina.
• The test is used to look for changes in the cells of the cervix and vagina that
show cancer or conditions that may develop into cancer
• The Pap test is done during a pelvic exam. A doctor uses a device called a
speculum to widen the opening of the vagina so that the cervix and vagina
can be examined. A plastic spatula and small brush are used to collect cells
from the cervix. After the cells are taken, they are placed into a solution.
The solution is sent to a lab for testing.
 TREATMENT
• Chemotherapy should be administered in conjunction with radiation
therapy to most patients with stage IB (high-risk) to stage IVA cervical
cancer.
 PREVENTION
• HPV vaccines
• All women in sexually active should begin cervical cancer testing
(screening) at age 21. Women aged 21 to 29, should have a Pap test
every 3 years. HPV testing should not be used for screening in this age
group (it may be used as a part of follow-up for an abnormal Pap
test).
• Begnning at age 30, the preferred way to screen is with a Pap test
combined with an HPV test every 5 years. This is called co-testing and
should continue until age 65.
 REFERENCES
• Schorge, Schaffer, Halvorson, Hoffman, Bradshaw, et al. Williams Gynecology.
McGraw-Hill’s
• Boardman CH. Cervical Cancer. Available at
http://emedicine.medscape.com/article/253513-overview. Accessed: September
16, 2015
• Cervical Cancer. Available at http://www.cdc.gov/cancer/cervical/. Accessed
September 16, 2015
• The American Cancer Society guidelines for the prevention and early detection of
cervical cancer. Available at http://www.cancer.org/cancer/cervicalcancer/.
Accessed: September 16, 2015
• Pusat Data dan Informasi Kementerian Kesehatan RI. Stop Kanker. Available at
www.depkes.go.id/download.php?file=download/pusdatin/...kanker.pdf.
Accessed September 16, 2015