Cervical Cancer Staging Criteria

Written by Gong Chun
Oncology
Updated on September 04, 2024
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For the staging of cervical cancer, the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO) are now adopted. Staging should be done before treatment, and since the FIGO staging of the cervix mainly relies on the examination of the pelvis, it is emphasized that the pelvic examination must be performed by two senior gynecologic oncologists. The staging primarily involves assessing the size of the cervical lesion, particularly the measurement of endophytic tumors, parametrial tissue infiltration, and the status of pelvic lymph nodes. However, these stages mainly rely on radiological examinations, primarily magnetic resonance imaging (MRI), to provide objective data for staging.

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How long does it take for cervical cancer to develop?

The causes of cervical cancer are now clear; it is caused by an infection with the HPV virus. Generally, this virus needs to be carried for more than two to three years before it can infect and develop into cervical cancer. There is a process of carcinogenesis where normal epithelial tissue transforms into cervical intraepithelial neoplasia. If the HPV infection is not treated and continues, it could lead to cervical cancer. Thus, the development process is relatively long, typically requiring two to three years. It is recommended that sexually active women undergo cervical cancer screening to check for any pathological changes in the cervix, including HPV, TCT, and colposcopy examinations.

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There are several types of cervical cancer vaccines.

There are three types of cervical cancer vaccines: bivalent, quadrivalent, and nonavalent, and the recommended vaccination ages vary for each. The bivalent cervical cancer vaccine is suitable for females aged 9 to 45; the quadrivalent vaccine is suitable for females aged 20 to 45; the nonavalent vaccine is suitable for females aged 16 to 26. Vaccinations can be scheduled at hospitals within these age ranges. The younger the age at vaccination, the higher the antibody production after receiving the cervical cancer vaccine, meaning the effectiveness is better.

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Causes of cervical cancer

The causes of cervical cancer are closely related to several factors. Firstly, infection with the human papillomavirus (HPV) is highly related and is the fundamental cause of precancerous lesions and cervical cancer. Secondly, although HPV DNA is not detected in the tumor tissues of a minority of cases, particularly among older patients, epidemiological surveys indicate that early childbirth and multiple childbearing are closely related to the incidence of cervical cancer. Thirdly, it has been found that the incidence of cervical cancer in women is related to contact with high-risk men, such as those with penile cancer, prostate cancer, or those whose ex-wives had cervical cancer. Fourthly, smoking has a certain relationship with the incidence of cervical cancer as it can inhibit the body's immune function. Alcohol consumption, irregular diet, and lifestyle also have certain relationships with the incidence of cervical cancer.

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Late-stage symptoms of cervical cancer

What are some symptoms of late-stage cervical cancer? First, there may be vaginal bleeding, characterized by irregular vaginal bleeding. The amount of bleeding varies depending on the size of the lesion and the invasion of interstitial blood vessels. In the late stages, as major blood vessels may be eroded, significant bleeding can occur. The second symptom is vaginal discharge, which is often increased and may be white or blood-stained. Third, late-stage symptoms may include secondary symptoms such as involvement of adjacent tissues and organs and affected nerves, leading to frequent urination, urgency, constipation, swelling and pain in the lower limbs. Cancer pressing on the ureters can cause obstruction of the ureters, hydronephrosis, and uremia. Late stages may also present with symptoms of systemic failure such as anemia and cachexia.

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Treatment of Cervical Cancer

The treatment principle of cervical cancer primarily focuses on surgical and radiotherapy, supplemented by chemotherapy and other comprehensive treatment plans. Therefore, it should be based on clinical staging and the specific condition of the patient, such as age and physical health, combined with the overall situation, as well as considering the level of technology and equipment conditions to develop a suitable treatment plan. Nowadays, emphasis is placed on personalized treatment and initial treatment. Cervical cancer treatment primarily involves surgery, including extensive hysterectomy and extensive cervical excision, where choosing the appropriate surgical method is key. Post-surgery, radiotherapy can be combined, and for those unsuitable for surgery, preoperative radiotherapy is an option. Additionally, preoperative or postoperative adjuvant chemotherapy can also be considered.