Cervical Cancer: An Overview of Introduction, Types, Pathogenesis

Introduction

Table of Contents

Cervical cancer is a malignant neoplasm of the cervix, most commonly arising from the transformation zone of the cervix. It is one of the leading causes of cancer-related morbidity and mortality among women, especially in low- and middle-income countries. Persistent infection with high-risk Human Papillomavirus (HPV) is the primary etiological factor.

Types of Cervical Cancer

1. Squamous Cell Carcinoma (≈70–80%)

Originates from the ectocervical squamous epithelium

2. Adenocarcinoma (≈15–25%)

Arises from the endocervical glandular epithelium

3. Adenosquamous Carcinoma

4. Rare Types

Neuroendocrine carcinoma
Clear cell carcinoma

Pathogenesis

Persistent infection with high-risk HPV types (16, 18, 31, 33, 45)
Viral oncoproteins E6 and E7 inactivate p53 and RB tumor suppressor genes
Progression from Cervical Intraepithelial Neoplasia (CIN I–III) to invasive carcinoma
Genetic instability, dysregulated cell cycle, and angiogenesis lead to malignant transformation

Laboratory Diagnosis

Pap smear (Papanicolaou test) – screening test
HPV DNA testing – detection of high-risk HPV strains

Colposcopy with directed biopsy
Histopathology – confirmation and grading
Immunohistochemistry – p16, Ki-67
Imaging (MRI/CT/PET) – staging

Treatment

Early stages: Conization, hysterectomy
Locally advanced disease: Radiotherapy with concurrent chemotherapy (cisplatin)
Advanced/metastatic disease: Chemotherapy, targeted therapy, immunotherapy
Supportive care for symptom control

Prevention

HPV vaccination (bivalent, quadrivalent, nonavalent vaccines)
Regular cervical screening (Pap smear/HPV testing)
Safe sexual practices
Smoking cessation
Public awareness and early detection programs

Keynotes

HPV infection is the central cause of cervical cancer.
A Pap smear is an effective screening tool for cervical cancer.
Vaccination can prevent most cases.
Early-stage disease has an excellent prognosis.
Combined screening and vaccination have a significant impact on reducing the disease burden.

Cervical Cancer: An Overview of Introduction, Types, Pathogenesis, Lab Diagnosis, Treatment, Prevention, and Keynotes