Cervical Cancer

By: Akshat Agarwal

SRHU-79
Session Outline
● Introduction
● Classification
● Etiology
● Pathology
● Clinical Features
● Diagnosis
● Differential Diagnosis
● Staging
Introduction
● Ca cervix is 4th most common cancer among women
worldwide and 2nd most common cancer among women
in India.
● Majority of CA cervix cases are diagnosed between 35 &
55 years.
● Until recently,CA cervix was linked with many viral
infections as the cause, e.g CMV, HSVll & is now
attributable to infection with Human Papilloma Virus (HPV)
.
● More than 150 subtypes of HPV have been described.
● They are divided into
Low Risk HPV 6 & 11

High Risk HPV 16,18,31,33,45,52,58

● Screening for HPV is very important in prevention &

management of Cervical cancer. (Universal Screening)
● Modalities include Pap smear, HPV DNA testing & visual
inspection with acetic acid.
Brief Anatomy
● Cervix divided into Endocervix (Columnar epithelium) &
Exocervix (Non keratinised stratified squamous
epithelium)
● Original SCJ lies at external os & due to squamous
metaplasia new SCJ is formed.
● The zone between original SCJ & New SCJ is known as
transformation zone(TZ)
● Mc site of CA cervix is TZ.
● Endocervix is mc site for Adenocarcinoma.
Classification
According to BETHESDA SYSTEM of classification
Disorders detected on Pap smears
Squamous cell abnormalities
● Atypical squamous cells (ASC)
● ASC-US - undetermined significance
● ASC-H - Not exclude high grade
● Low grade Squamous intraepithelial lesion (LSIL)
● High grade Squamous intraepithelial lesion (HSIL)
● Squamous cell carcinoma
Glandular cell Abnormalities
● Atypical Glandular cells (AGC)
● Adenocarcinoma in Situ (AIS)
● Adenocarcinoma
LSIL on Pap smear ~ CIN 1 on HPE
HSIL on Pap smear ~ CIN 2/3 on HPE
Histological Classification

● Squamous cell carcinoma

● Adenocarcinoma
● Adenosquamous carcinoma
● Clear cell carcinoma
● Rare types such as neuroendocrine carcinoma
Thank You

Moving on to Aetiology