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06-16-2006, 07:50 AM
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Cervical Cancer
Cervical Cancer
Cervical cancer is a malignancy of the cervix. Worldwide, it is the second most common cancer of women. It may present with vaginal bleeding but symptoms may be absent until the cancer is in advanced stages, which has made cervical cancer the focus of intense screening efforts utilizing the Pap smear. Most scientific studies have found that human papillomavirus (HPV) infection is responsible for >90% of the cases of cervical cancer. There are 7 most common types of HPV - 16, 18, 31, 33, 42, 52 and 58.[1] Types 16 and 18 being the most common cause of the cancer. Treatment is with surgery (including local exicision) in early stages and chemotherapy and radiotherapy in advanced stages of the disease. An effective vaccine for the two most common strains of HPV has recently been licenced. Signs & Symptoms The early stages of cervical cancer may be completely asymptomatic (Canavan & Doshi, 2000). Vaginal bleeding, contact bleeding or (rarely) a vaginal mass may indicate the presence of malignancy. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere. The possibility to identify premalignant changes on a cervical smear has made screening the major cause for referral of women with possible cervical neoplasia. In many countries, women are advised to have a regular Pap smear to check for premalignant changes.[2] Recommendations for how often a Pap smear should be done vary from once a year to once every five years. If cervical cancer is detected early, it can be treated without impairing fertility. Consistently abnormal smears may be a reason for further diagnosis despite complete absence of symptoms. Diagnosis Diagnosis is made by doing a biopsy of the cervix, which often involves colposcopy, or a magnified visual inspection of the cervix aided by using an acetic acid (e.g. vinegar) solution to highlight abnormal cells on the surface of the cervix (the portio). A Pap smear is insufficient for the diagnosis. Many researchers recommend that since more than 99% of invasive cervical cancers worldwide contain human papillomavirus, HPV testing should be carried out together with routine cervical screening (Walboomers et al, 1999). However, given the prevalence of HPV (around 80% infection history among the sexually active population) others suggest that routine HPV testing would cause undue alarm to carriers. Further diagnostic procedures are loop electrical excision procedure (LEEP) and conisation, in which the inner lining of the cervix is removed to be examined pathologically. These are carried out if the biopsy confirms severe dysplasia. Source: http://en.wikipedia.org/wiki/Cervical_cancer
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