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Cervical Cancer (cont.)

How Do Physicians Determine Cervical Cancer Staging?

Precancerous Changes

Over the years, different terms have been used to refer to abnormal changes in the cells on the surface of the cervix. These changes are now most often called squamous intraepithelial lesion (SIL). "Lesion" refers to an area of abnormal tissue; intraepithelial means that the abnormal cells are present only in the surface layer of cells. Changes in these cells can be divided into two categories.

  • Low-grade SIL: Early, subtle changes in the size and shape of cells that form the surface of the cervix are considered low grade.
    • These lesions may go away on their own, but over time, they may become more abnormal, eventually becoming a high-grade lesion.
    • SIL is also called mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1).
    • These early changes in the cervix most often occur in women aged 25-35 years but can appear in women of any age.
  • High-grade SIL: A large number of precancerous cells, which look very different from normal cells, constitute a high-grade lesion.
    • Like low-grade SIL, these precancerous changes involve only cells on the surface of the cervix.
    • These lesions are also called moderate or severe dysplasia, CIN 2 or 3, or carcinoma in situ.
    • They develop most often in women aged 30-40 years but can occur at any age.

Precancerous cells, even high-grade lesions, usually do not become cancerous and invade deeper layers of the cervix for many months, perhaps years.

A woman should ask her health-care professional if she does not understand the way the result of her Pap smear is reported.

Invasive Cancer

If abnormal cells spread deeper into the cervix or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. Cervical cancer occurs most often in women aged 40 years or older, though it can be found in younger women.

If the biopsy results show invasive cancer, a series of tests will be performed, all designed to see whether the cancer has spread and, if so, how far. The extent of spread of a cancer is referred to as the stage of the cancer.

  • A chest X-ray looks for spread to the lungs.
  • Blood tests can indicate whether the liver is involved. A CT scan may be necessary if results are not definitive.
  • Special X-rays or a CT scan can be used to look at the bladder and other organs.
  • The vagina and rectum are also examined, sometimes under anesthesia.

These tests are used to "stage" the cancer.

  • By finding out how far it has spread, a health-care professional can make a reasonable guess about a woman's prognosis and the kind of treatment she will need.
  • Cervical cancer is staged from stage 0 (earliest and least severe) to stage IV (metastatic disease, advanced and the most severe).
  • Staging is based on size and depth of the cancerous lesion, as well as degree of spread.
Medically Reviewed by a Doctor on 11/20/2017

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Cervical cancer is the second most common malignancy in women worldwide, and it remains a leading cause of cancer-related death for women in developing countries.

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