Cervical Cancer Staging Criteria

Written by Gong Chun
Oncology
Updated on September 04, 2024
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For the staging of cervical cancer, the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO) are now adopted. Staging should be done before treatment, and since the FIGO staging of the cervix mainly relies on the examination of the pelvis, it is emphasized that the pelvic examination must be performed by two senior gynecologic oncologists. The staging primarily involves assessing the size of the cervical lesion, particularly the measurement of endophytic tumors, parametrial tissue infiltration, and the status of pelvic lymph nodes. However, these stages mainly rely on radiological examinations, primarily magnetic resonance imaging (MRI), to provide objective data for staging.

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Characteristics of Bleeding in Cervical Cancer

The bleeding characteristics of cervical cancer should be considered based on the pathological type and stage of the disease. In the early stages, the bleeding may be contact-related, occurring after sexual intercourse or a gynecological examination, and may involve a small amount of fresh, light bleeding. As the disease progresses into the later stages, the tumor may cause irregular vaginal bleeding. The amount of this irregular bleeding varies, depending on the size of the lesion and the involvement of the blood vessels in the interstitial tissues. A larger lesion may naturally result in more bleeding. In advanced stages, major blood vessels may be affected, potentially leading to severe bleeding. Therefore, the characteristics of vaginal bleeding should be analyzed based on the specific circumstances. If the cancer is exophytic, bleeding tends to occur earlier and is usually more copious, whereas if it is endophytic, bleeding tends to occur later.

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Causes of cervical cancer

The causes of cervical cancer are closely related to several factors. Firstly, infection with the human papillomavirus (HPV) is highly related and is the fundamental cause of precancerous lesions and cervical cancer. Secondly, although HPV DNA is not detected in the tumor tissues of a minority of cases, particularly among older patients, epidemiological surveys indicate that early childbirth and multiple childbearing are closely related to the incidence of cervical cancer. Thirdly, it has been found that the incidence of cervical cancer in women is related to contact with high-risk men, such as those with penile cancer, prostate cancer, or those whose ex-wives had cervical cancer. Fourthly, smoking has a certain relationship with the incidence of cervical cancer as it can inhibit the body's immune function. Alcohol consumption, irregular diet, and lifestyle also have certain relationships with the incidence of cervical cancer.

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Oncology
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Causes of Cervical Cancer

The causes of cervical cancer include: The first point is infection by the human papillomavirus (HPV), particularly persistent infection with high-risk types, which is the basic cause of precancerous lesions and cervical cancer. The second point is that DNA from HPV is not detected in the tumor tissues of a minority of cases, especially among some older patients. Epidemiology shows that early childbirth and multiparity are closely related to the occurrence of cervical cancer. With an increasing number of childbirths, the risk of cervical cancer also increases. This correlation might be due to the trauma to the cervix during childbirth and changes to the endocrine and nutritional states during pregnancy.

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Cervical cancer indicators

The main indicators of cervical cancer are still the examination of the cervix and cervical canal tissues. There are obvious cancerous changes, and under the microscope pathological sections can show tendencies of cell carcinogenesis, or already developed cancer. The second is the cytological examination of cervical scrapings, which detects the presence of cancer cells. The third is the iodine test, where areas that do not stain after iodine staining indicate a lack of glycogen in the epithelium, suggesting possible lesions. The fourth is colposcopy, which may reveal suspicious cancerous areas, allowing for biopsy to confirm cancer cells. The fifth includes ultrasound, CT, MRI, etc., which can detect mass occupying lesions, all of which are indicators of cervical cancer. Of course, abnormalities in tumor markers are also considered, but the main reliance is still on the indicators from pathological examinations to determine if it's cervical cancer.

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Oncology
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Staging of cervical cancer

The clinical staging of cervical cancer mainly uses the FIGO system, which adopts the staging criteria of the International Federation of Gynecology and Obstetrics (FIGO). Staging should be performed before treatment, and once done it does not change after treatment. Since FIGO staging of cervical cancer primarily relies on pelvic examination, it emphasizes the necessity of this examination being conducted by two experienced gynecologic oncologists. If needed, a pelvic examination under anesthesia is performed to ensure the accuracy of the evaluation. So, how is the staging performed? It involves measuring the size of the cervical lesion, particularly the measurement of endophytic tumors, the infiltration of cervical tissue, and the status of pelvic lymph nodes, providing accurate information with the aid of radiological data, especially magnetic resonance imaging (MRI).