Pre-invasive cervical disease and cervical carcinoma

Abstract

Until a few years ago cervical cancer was one of the commonest type of cancer in women worldwide. Its incidence decreased dramatically following the implementation of the Papanicolaou (Pap) smear as a screening procedure. The Pap smear can detect a wide range of abnormalities of the cervix from benign cellular changes to precancerous conditions. Part of this review, will focus on this issue, specifically the abnormal and/or possibly precancerous findings that can be found in a Pap smear result. These will be classified according to the Bethesda system. One must emphasize here that most of these abnormalities regress on their own and do not need specific treatment. Yet, findings like the High-grade Squamous Intraepithelial Lesion (HSIL) have a high rate of progression to cancer and necessitate immediate management. The other half of this review will focus on cervical cancer in itself, a malignant and therefore invasive disease which, like all other cancers, can be fatal if left untreated. The extent of spread of the cancer is determined by the staging system, here described according to the International Federation of Gynecology and Obstetrics (FIGO). Staging is an important means of evaluating the treatment plans used.