2. Cervical Cancer
Cancer in the cervix of the uterus is called cervical
cancer.
Cells change from normal to pre-cancer (dysplasia)
and then to cancer
Mainly occurs in the transitional zone.
3. Affects 16 per 100,000 women per year and dies about 9 per
100,000 per year in world Population.
Every year 452,000 new cases of cervical cancer are
detected, according to World Health Organization.
More than 2000 new cases being detected each year
in Nepal.
4.
5.
6. Squamous cell Carcinomas
Cancer of flat epithelial cell
80% to 90%
Adenocarcinoma
Cancer arising from glandular epithelium
10% to 20%
Mixed carcinoma
Features both types
7. Human Papilloma virus infection (HPV) – Primary factor
HPV 16, HPV 18, HPV 31, HPV 33, HPV 45
50% are caused by HPV 16 AND 18
Sexual behavior/ multiple sex partner.
Smoking
HIV infection /Immunocompromised state.
Chlamydia infection
Oral contraceptives
Multiple pregnancies.
8. HPV causes the production of two proteins known
as E6 and E7.
When these proteins are produced, they turn off
some tumor suppressor genes.
This may allow the cervical lining cells to grow
uncontrollably, which in some cases will lead to
cancer
9. Association of cervical cancer with oral
contraceptive use is likely to be indirect
The hormones in oral contraceptives may change the
susceptibility of cervical cells to HPV infection,
affect their ability to clear the infection, or make it
easier for HPV infection to cause changes that
progress to cervical cancer.
10. Vaginal bleeding
Menstrual bleeding is longer and heavier
than usual
Bleeding after menopause or increased
vaginal
discharge
Bleeding following intercourse or pelvic
exam
11. Cervical Cytology (Pap Test):
Cells are removed from the cervix and examined under the
microscope.
Can detect epithelial cell abnormalities
• Atypical squamous cells
• Squamous intraepithelial lesions
• Squamous cell carcinoma (likely to be invasive)
12. Colposcopy:
• Cervix is viewed through a colposcope and the surface of
the cervix can be seen close and clear.
Cervical Biopsies:
• Colposcopic biopsy – removal of small section of the
abnormal area of the surface.
• Endocervical curettage – removing some tissue lining
from the endocervical canal.
• Cone biopsy – cone-shaped piece of tissue is removed
from the cervix
13.
14. Surgery
Pre invasive cervical cancer
• Cryosurgery
• Laser surgery
• Conization
Invasive cervical cancer
• Simple hysterectomy
Removal of the body of the uterus and cervix.
• Radical hysterectomy and pelvic lymph node
dissection
Removal of entire uterus, surrounding tissue , upper
part of the vagina, and lymph nodes from the cervix.
Radiation
Chemotherapy
Follow up after treatment.
15. Avoiding the risk factors
Especially HPV
Long term use of OCP
Having the Pap Test
3 years after first vaginal intercourse or by
age 21 years.
Have test annually
Use physical barrier for safe sex.