Alerts and Notices
SynopsisCervical cancer is a malignant neoplasia of the uterine cervix. Greater than 99% of cervical cancer is known to be a result of infection with the human papillomavirus (HPV). HPV is the most common sexually transmitted infection (STI) among both men and women. HPV infection is usually self-limited, and women with a normal immune system will clear the infection typically within 8-24 months. If the infection is not cleared, it can progress to preinvasive disease, which in some cases can then progress to invasive cancer. This progression usually takes many years – often more than a decade. The primary risk factor for developing cervical cancer is infection with HPV. Other risk factors include smoking, multiple sexual partners, young age of first sexual intercourse, and immunosuppression.
Typically, cervical cancer is diagnosed in women aged older than 30 years. Peak incidence is in the late 40s. The vast majority of women have no symptoms, and the first sign of an abnormality is noted on routine screening. If symptoms are present, they may include abnormal vaginal discharge, abnormal vaginal bleeding, or postcoital bleeding. Symptoms of advanced disease are typically from mass effect leading to low back or pelvic pain, obstructive renal failure, or leg edema.
C53.9 – Malignant neoplasm of cervix uteri, unspecified
363354003 – Malignant tumor of cervix
Differential Diagnosis & Pitfalls
- Cervical polyp
- Pelvic inflammatory disease / cervicitis – STI testing should be completed; cervical motion tenderness is not typically seen with cervical cancer.
- Condyloma acuminata (genital warts)
- Nabothian cyst – Small yellow / white "pearly"-appearing cysts on the cervix; these are normal and need no intervention.
- Cervical ectropion
- Prolapsing uterine fibroid (leiomyoma) – Fleshy, tan-colored mass, typically mobile; a stalk is often seen in the cervical os.
- Prolapsing uterine polyp – Similar to prolapsed fibroid except more friable.
Drug Reaction DataBelow is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.