Disorders of the Cervix
HPV screening will soon be the 1st line.
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
Copyright © August 1999 The American College of Obstetricians and Gynecologists
Disorders of the cervix are common. They range from fairly mild problems, such as infection and inflammation, to more serious ones, such as cancer.The Cervix
The cervix is the lower, narrow end of the uterus. It opens into the vagina. The cervix is covered by a thin layer of tissue (like the skin inside your mouth).
Types of Cervical Disorders
Cervicitis
Cervicitis is an inflammation of the cervix that may or may not cause symptoms. It is common in women during their childbearing years. Causes of cervicitis include:
- Infections, especially with an organism that can be passed through sex
- Irritation from a foreign body
In some cases, the cause of cervicitis cannot be found.
Polyps
Polyps are benign (not cancer) growths or tumors that often appear on the cervix. Polyps vary in size and may cause vaginal bleeding. They often can be found during a pelvic exam or with colposcopy. In most cases, polyps can be removed in the office. Anesthesia is not needed in most cases.
Genital Warts
Genital warts, also called condyloma, are spreading growths that are caused by some types of human papillomavirus (HPV). The virus is most often passed during sex.
Dysplasia
Dysplasia is a type of cervical disorder that occurs when there is a change in the cells on the surface of the cervix. Normal, benign cells are replaced by abnormal cells. It is not cancer. The abnormal cells can turn into cancer cells if they are not treated.
Other terms may be used to report cervical changes on a Pap test. These include cervical intraepithelial neoplasia (CIN) and squamous intraepithelial lesion (SIL).
Invasive Cervical Cancer
A disorder of the cervix becomes serious — invasive cancer — when it moves into deeper tissue layers or spreads to other organs.
Because cervical cancer most often develops after abnormal cells have been present for a number of years, it tends to affect women aged 35 to 50. Cervical cancer can occur at any age, though.
Often there are no symptoms of cervical cancer. When symptoms do occur, the first sign may be abnormal bleeding, spotting or discharge from the vagina.
If tests show that a woman has cancer, her doctor will determine the size of the tumor and the extent (if any) to which it has spread. This is referred to as its stage. Stages range from I to IV
Your doctor may consult with, or refer you to, a gynecologic oncologist (a specialist in treating cancer in women) or a radiation oncologist (a specialist in using radiation to treat cancer). They will work as a team to choose treatment that meets your needs.
Diagnosis of Cervical Disorders
The key to successful treatment of disorders of the cervix is finding them early. This includes a pelvic exam and Pap test.
The Pap Test
For most women, a Pap test done each year, starting at age 18 or sooner if they have sex, is the best screening method for finding changes in the cervix.
A Pap test can be done in your doctor’s office during a regular pelvic exam.
If the Pap test shows abnormal cells, your doctor will explain the results to you.
Colposcopy
Colposcopy is the next test performed if a Pap test is abnormal. It is a way of looking at the cervix through a special magnifying instrument called a colposcope. It lets your doctor detect problems of the cervix that cannot be seen with the eye alone.
Biopsy
When abnormalities of the cervix are seen by colposcopy, a biopsy may be done to diagnose the problem.
If a larger sample is needed, conization may be done. Through surgery, a cone-shaped wedge of the cervix is removed. The sample is then examined under a microscope. Conization requires general or regional anesthesia in most cases.
Methods of Treatment
Treatment of cervical disorders depends on the type of problem. For instance, mild cervicitis may be treated with medicines such as antibiotics.
Minor surgery may be used to treat genital warts, dysplasia and early stages of cancer.
Most cases of dysplasia, including CIS, may be treated with one of these methods.
Early-stage cancer of the cervix in young, healthy women most often is treated with a hysterectomy.
Late-stage cervical cancer and cervical cancer in older or less healthy women are most often treated with radiation.
Finally …
Don’t take chances if you think that you may have a problem. The best results occur when cervical disorders are found and treated early. Have a complete pelvic exam, which includes a Pap test, once a year.