Foundations
- Postcoital bleeding, intermenstrual bleeding, discharge; a visible or palpable cervical lesion is biopsied, never screened.
- Squamous cell (about 75 percent) and adenocarcinoma; both HPV-driven.
- FIGO 2018 staging: I confined to the cervix (IA microscopic, IB visible by size), II beyond the uterus but not to the pelvic wall or lower third of vagina, III to the pelvic wall, lower vagina, hydronephrosis or lymph nodes, IV bladder, rectum or distant. Imaging and pathology now inform the stage.
- Treatment: cone biopsy or simple hysterectomy for IA; radical hysterectomy with lymph node assessment for IB1 to IB2 (fertility-sparing radical trachelectomy in selected cases); chemoradiation with brachytherapy for IB3 and beyond; systemic therapy with immunotherapy for advanced disease.
- Prevention is the story: vaccination and screening.
On the modelCervixVaginaBroad and round ligaments