Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- PART VII Respiratory system
- PART VIII Bone and soft tissue
- PART IX Skin
- PART X Breast and genitourinary system
- 40 Breast
- 41 Uterine cervix
- 42 Choriocarcinoma
- 43 Endometrium (corpus uteri)
- 44 Ovary
- 45 Prostate
- 46 Testis
- 47 Penis and scrotum
- 48 Urinary tract, bladder, ureter and urethra
- 49 Kidney and renal pelvis
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
41 - Uterine cervix
Published online by Cambridge University Press: 03 May 2010
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- PART VII Respiratory system
- PART VIII Bone and soft tissue
- PART IX Skin
- PART X Breast and genitourinary system
- 40 Breast
- 41 Uterine cervix
- 42 Choriocarcinoma
- 43 Endometrium (corpus uteri)
- 44 Ovary
- 45 Prostate
- 46 Testis
- 47 Penis and scrotum
- 48 Urinary tract, bladder, ureter and urethra
- 49 Kidney and renal pelvis
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
Summary
Introduction
Cervical cancer is the second most frequent cancer in women on a worldwide basis, but it is the most frequent cancer in developing countries even when both sexes are considered (Parkin et al., 1988). It shows large geographical variations and temporal changes.
Histology, classification and diagnosis
About 95% of these cancers are squamous cell carcinomas, the others adenocarcinomas. It is now accepted that invasive squamous cell carcinoma arises from precursor lesions of the cervix such as dysplasia and carcinoma in situ. There is a recent trend to use the term cervical intra epithelial neoplasia (CIN) to cover the postulated sequence of cellular changes from mild dysplasia to in situ carcinoma. Information on the lesions preceding dysplasia is limited.
While the pathological diagnosis of invasive carcinoma is straightforward, the cytological and histological diagnosis of CIN can be difficult, as illustrated in distinguishing CIN from sub-clinical human papilloma virus (HPV) infection by morphology only. The use of nomenclature based on the three degrees of CIN instead of three degrees of dysplasia plus carcinoma in situ may be ambiguous in regard to the clinical implications and complicate the interpretation of reports on prevalence. Accordingly, a new classification for cytology (The Bethesda System) has been proposed grouping squamous intraepithelial lesions (SIL) in two categories: low-grade SIL (previously mild dysplasia or CIN-I) and highgrade SIL (previously moderate and severe dysplasia, carcinoma in situ or CIN-II and CIN-III).
- Type
- Chapter
- Information
- Human CancerEpidemiology and Environmental Causes, pp. 388 - 394Publisher: Cambridge University PressPrint publication year: 1992