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1、Cervix,Lower part of the uterus Connects the body of the uterus to the vagina (birth canal) Source: American Cancer Society,Statistics,10,520 new cases in the U.S. this year 3,900 will die 50% are diagnosed between ages 35 and 55. 20% at the age of 65 or over. Rarely occurs in women younger than 20
2、Noninvasive is four times more common 74% decrease in deaths between 1955 and 1992 in the U.S. Death rate continuous to decline by 2% a year Source: American Cancer Society,Three Types,Squamous cell Carcinomas Cancer of flat epithelial cell 80% to 90% Adenocarcinomas Cancer arising from glandular ep
3、ithelium 10% - 20% Mixed carcinoma Features both types,Cervical Cancer,Begins in the lining of the cervix Cells change from normal to pre-cancer (dysplasia) and then to cancer,Risk Factors,Human papillomavirus infection (HPV) Primary factor HPV 16, HPV 18, HPV 31, HPV 33, HPV 45 50% are caused by HP
4、V 16 AND 18 Sexual behavior Smoking HIV infection Chlamydia infection Diet Oral contraceptives Multiple pregnancies Low socioeconomic status Diethylstilbestrol (DES) Family history Source: American Cancer Society,Signs and Symptoms,Vaginal bleeding Menstrual bleeding is longer and heavier than usual
5、 Bleeding after menopause or increased vaginal discharge Bleeding following intercourse or pelvic exam Pain during intercourse Source: American Cancer Society,Diagnosis,Cervical Cytology (Pap Test) Cells are removed from the cervix and examined under the microscope. Can detect epithelial cell abnorm
6、alities Atypical squamous cells Squamous intraepithelial lesions Squamous cell carcinoma (likely to be invasive) Source: American Cancer Society,Diagnosis,Additional testing Colposcopy Cervix is viewed through a colposcope and the surface of the cervix can be seen close and clear. Cervical Biopsies
7、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,Staging,FIGO System (International Federation Of Gynecology and Obstetri
8、cs) Has five stages 0 to 4 Stage 0 Carcinoma in situ Stage 1 Invaded cervix, but has not spread. Stage 2 Has spread to nearby areas, not leaving pelvic area. Stage 3 Cancer has spread to the lower part of the vagina. Stage 4 Cancer has spread to nearby organs; metastasis. Source: American Cancer Soc
9、iety,Survival Rate,5-year survival rate is 92% for earliest stage 71% for all stages combined Source: American Cancer Society,Treatment,Surgery Preinvasive cervical cancer Cryosurgery Laser surgery Conization Invasive cervical cancer Simple hysterectomy Removal of the body of the uterus and cervix.
10、Radical hysterectomy and pelvic lymph node dissection Removal of entire uterus, surrounding tissue, upper part of the vagina, and lymph nodes from the cervix. Radiotherapy Chemotherapy Source: American Cancer Society,Prevention,Avoiding the risk factors Especially HPV Help for low-income women (NBCCEDP) Having the Pap Test 3 years after first vaginal intercourse or by age 21. Have test annually Source: American Cancer Society,NCCN Guidelines 2010 v.,Thank You,