Cervical cancer
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of cervical cancer.
Alternative Names
Dysplasia; Human papillomas virus; Pap smear
Prognosis
The following are some examples of the time it takes for early stages of cervical dysplasia to progress to the next stage:
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Only about 1% of untreated mild cervical dysplasia (CIN I) cases progress to severe dysplasia or cancer each year.
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In women with untreated moderate dysplasia (CIN II), 16% will progress to the next stage in 2 years, while 25% will progress after 5 years.
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Most untreated carcinomas in situ will develop into invasive cancers over a period of 10 - 12 years.
Survival Rates in Women with Cervical Cancer
Over the past 30 years, the death rate from cervical cancer has declined significantly. In general, 71% of women with invasive cervical cancer survive for 5 years or more. African American women tend to have poorer 5-year survival rates than Caucasian women, although survival rates have significantly increased in African American women in recent years.
The outlook for specific women varies depending on different factors:
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In women who receive treatment when cervical cancer is still local, the cure rate is about 90%. Experts say universal screening could essentially reduce the cervical cancer death rate to zero. Still, only 12 - 15% of women have routine Pap smears. As a result, only 55% of white women and 44% of African American women are diagnosed at early stages.
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If the cancer cells have spread beyond the cervix, the average 5-year survival rates may drop to 50% and below, depending on how much it has spread and the type of cancer cell.
Identifying what type of HPV a woman has may help determine outlook and the severity of cervical cancer. For example, HPV 18 and HPV 16 are associated with severe cases. HPV 16 has also been linked to a rare form of cervical and uterine cancers.
Other biochemical markers in the body may also help predict outcome and treatment. For example, women with cervical cancer who have high levels of an enzyme called cyclooxygenase (COX-2) may require more aggressive treatments than those with low levels.
Consequences of Treatments
The treatments for advanced cervical cancer also add to the emotional burden in premenopausal women, because they nearly always prevent future childbearing.
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Review Date: 9/1/2006
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Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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