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Cervical cancer (CC), cancer of the uterine cervix or cancer of the cervix is the presence of malignant (cancerous) cells in the tissues that form part of the cervix. The cervix or neck of the uterus is the lower portion of the uterus and connects the body of the uterus (uterine cavity) with the vagina.
As such, the cervix forms a channel that leads to the vagina and outside the body. The mucous membrane lining the cervix in the vicinity of the vagina is called the ectocervix, while the membrane lining the cervical canal up to the uterine cavity is called the endocervix. Most tumours develop where the ectocervix joins the endocervix.
Cervical cancer usually forms slowly over time. Before this cancer forms, the cells in the cervix undergo certain changes (dysplasia) until abnormal cells start to appear in the tissues of the cervix. Over time the abnormal cells eventually turn into cancer cells, multiply and spread into the deepest part of the uterine cervix and surrounding areas.
Types of Cervical Cancer
Cervical cancers and precancerous lesions are classified according to what the cells look like when observed under a microscope.
Squamous cell carcinoma. This is by far the most common type of cervical cancer (90%). It develops from precancerous lesions in the external lining of the cervix, which consists of several layers of cells that shed (squamous epithelium) and develop into squamous cell cancers if they become malignant.
Adenocarcinoma. Much less frequently, the epithelium lining the internal portion of the cervical canal, which is formed by a single layer of glandular or mucus-secreting cells, becomes malignant and produces a glandular cell cancer or adenocarcinoma.
Malignant tumours that originate in other types of cell (muscle, blood vessels, stroma, hormone- or melanin-producing cells) are very rare and give rise to sarcomas, carcinomas, neuroendocrine tumours, melanomas, etc. Metastasis to the cervix (the growth of tumours that originally developed in another organ) are extremely rare.
Classification according to the size and spread
STAGE I. Microinvasive tumours that are invisible to the naked eye and can only be diagnosed by microscopy (Stage IA) or visible tumours that are still confined to the cervix (Stage IB).
STAGE II. Tumours that have spread into neighbouring tissues such as the ligaments that attach the cervix to the pelvic wall (parametrium) or the vagina.
STAGE III. Tumours that extend into the lower portion of the vagina (Stage IIIA) or the pelvic wall (Stage IIIB).
STAGE IV. Tumours that now affect the inside of the bladder or rectum (Stage IVA) or metastasis to distant organs (Stage IVB).
How many women does it affect?
Cervical cancer is the fourth most common cancer worldwide. Approximately 80% of cases are diagnosed in developing countries that do not have screening and prevention or vaccination programmes in place. In Europe, around 35,000 new cases are diagnosed each year (it affects 1 in 110 women at some point in their lifetime). The maximum prevalence is seen in women aged 45–55 years. Cervical cancer is the second most frequent cancer affecting women in Europe under the age of 45. In Spain, it is estimated to affect 7 in every 100,000 women. Around 2,100 new cases are diagnosed each year and it is responsible for about 800 deaths.