Cervical cancer staging

Cervical cancer staging is the assessment of cervical cancer to decide how far the disease has progressed. Cancer staging generally runs from stage 0, which is pre-cancerous or non-invasive, to stage IV, in which the cancer has spread throughout a significant part of the body.[1]

Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, rather than surgical findings.[2] It allows only the following diagnostic tests to be used in determining the stage: palpation (feeling with the fingers), inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, and X-ray examination of the lungs and skeleton, and cervical conization.

Stages
  • Stage 1A cervical cancer
  • Stage 1B cervical cancer
  • Stage 2A cervical cancer
  • Stage 2B cervical cancer
  • Stage 3B cervical cancer
  • Stage 4A cervical cancer
  • Stage 4B cervical cancer
Stage 0
The carcinoma is confined to the surface layer (cells lining) of the cervix. Also called carcinoma in situ (CIS).
Stage I
The carcinoma has grown deeper into the cervix, but has not spread beyond it (extension to the corpus would be disregarded). Stage One is subdivided as follows:
IA Invasive carcinoma which can be diagnosed only by microscopy, with deepest invasion ≤5 mm and the largest extension ≤7 mm
IA-1 Measured stromal invasion of ≤3.0 mm in depth and extension of ≤7.0 mm
IA-2 Measured stromal invasion of >3.0 mm and not >5.0 mm with an extension of not >7.0 mm
IB Clinically visible lesions limited to the cervix uteri or pre-clinical cancers greater than stage IA
IB-1 Clinically visible lesion <4.0 cm in greatest dimension
IB-2 Clinically visible lesion >4.0 cm in greatest dimension
Stage II
Cervical carcinoma invades beyond the uterus, but not to the pelvic wall or to the lower third of the vagina
IIA Without parametrial invasion
IIA-1 Clinically visible lesion <4.0 cm in greatest dimension
IIA-2 Clinically visible lesion >4.0 cm in greatest dimension
IIB With obvious parametrial invasion
Stage III
The tumour extends to the pelvic wall and/or involves lower third of the vagina and/or causes hydronephrosis or non-functioning kidney
IIIA Tumour involves lower third of the vagina, with no extension to the pelvic wall
IIIB Extension to the pelvic wall and/or hydronephrosis or non-functioning kidney
Stage IV
The carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum. A bullous oedema, as such, does not permit a case to be allotted to Stage IV
IVA Spread of the growth to adjacent organs
IVB Spread to distant organs[3]

References
  1. "Staging". National Cancer Institute. Retrieved 2018-11-07.
  2. "Cervical Cancer Stages". www.cancer.org. Retrieved 2018-11-07.
  3. Rosdahl, Caroline (2012). Textbook of basic nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 1550. ISBN 1605477729.
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