Cervical Cancer

Description

Alternative Names

Prognosis

The following are some examples of the time it takes for early stages to progress to the next stage:

• Only about 1% of untreated mild cervical dysplasia (CIN I) cases progress to severe dysplasia or cancer each year.
• In women with untreated moderate dysplasia (CIN II), the risk for progression is 16% by two years and 25% after five years.
• Most untreated carcinomas in situ will develop into invasive cancers over a period of 10 to 12 years.

Survival Rates in Women with Cervical Cancer

Over the past 30 years, the death rate from cervical cancer has declined significantly. Since 1982, mortality rates have declined at an average of about 1.6% per year. About 4,100 American women are expected to die of the disease in 2003. In general, 71% of women with invasive cervical cancer survive for five years or more. African American women have poorer five-year survival rates (61%) than Caucasian women (72%), although survival rates have significantly increased in African American women in recent years.

The outlook for specific women varies depending on different factors:

• In women who receive treatment when cervical cancer is still local, the cure rate is about 90%. (Universal screening could then essentially reduce the cervical cancer death rate to zero. Still, only 12% to 15% of women have routine Pap smears. As a result, only 55% of white women and 44% of African American women are diagnosed at early stages.)
• If the cancer cells have spread beyond the cervix, the average five-year survival rates may drop to 50% and below depending on the extent of the invasion and the type of cancer cell.

Identifying the genetic type of any present human papillomavirus may prove to be important for determining outlook and severity of cervical cancer. For example, genetic types, HPV 18 and HPV 16, are associated with severe cases. HPV 16 has also been linked to a rare form of cervical and uterine cancers.

Other markers may also help predict outcome and treatment. For example, women with cervical cancer who have high levels of an enzyme called cyclooxygenase (COX-2) may require more aggressive treatments than those with low levels.

Consequences of Treatments

The treatments for advanced cervical cancer also add to the emotional burden in premenopausal women, because they nearly always prevent future childbearing.