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Cervical Cancer: Pathology Report and Staging

Cervical Intraepithelial Neoplasia:
Cervical intraepithelial neoplasia (CIN) is an abnormal condition that is detectable by Pap smears and other cervical exams. CIN is the growth of abnormal cells in the lining of the cervix. Though CIN it is not cancerous, it has the potential to progress to cancer if left untreated. There are three stages (or grades) of CIN: CIN 1, CIN 2 and CIN 3. The stages are define by how abnormal the cells appear, slight, moderate and high. The risk of cancer development increases with increasing CIN grade. CIN is relatively common, with 1.4 million low grade and 330,000 high grade cases diagnosed in the United States in 2006. Cervical lesions are treated depending on the degree of severity. CIN 1 lesions may be removed or closely monitored; CIN 2/3 lesions are usually surgically removed. In either case, careful follow-up screening is performed to ensure that there is no recurrence. Despite the high incidence of CIN, if these irregularities are treated, progression to cancer is very rare. (1) The image below shows microscopic images of normal cervical tissue, CIN 1, CIN 2 and CIN 3



Image courtesy of Talaat S Tadros MD, Emory University School of Medicine.

Cervical Cancer Staging:
If a lesion is determined to be cancerous, the disease is staged. Staging is typically based on guidelines produced by the Federation Internationale de Gynecologie et d' Obstetrique (FIGO). In this system tumors are classified by their size and location. An alternative system is used by the American Joint Committee on Cancer (AJCC). (2) Staging of the cancer helps the clinicians to design an appropriate plan of treatment.

View the FIGO guide to cervical cancer staging.
Visit the AJCC website.

References for this page:
  1. Wright TC Jr, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D; for the 2006 American Society for Colposcopy and Cervical Pathology-sponsored Consensus Conference. 2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. J Low Genit Tract Dis. 2007 Oct;11(4):223-39. [PUBMED]
  2. Benedet, JL. Staging Classifications and Clinical Practice Guidelines for Gynaecological Cancers. International Journal of Gynecology and Obstetrics, 70 (2000) 207-312. (pg 37-62) [http://www.figo.org/docs/staging_booklet.pdf]
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