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Cervical cancer
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Cervical cancer

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Contributors: Daniel G. Terk MD, Mitchell Linder MD
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Synopsis

Cervical 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 pre-invasive 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 over the age of 30. 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.

Codes

ICD10CM:
C53.9 – Malignant neoplasm of cervix uteri, unspecified

SNOMEDCT:
363354003  – Malignant tumor of cervix

Look For

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Diagnostic Pearls

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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.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below 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.

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References

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Last Reviewed: 08/10/2017
Last Updated: 08/10/2017
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Cervical cancer
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Cervical cancer : Cigarette smoking, Vaginal bleeding, Vaginal discharge
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