Cervical cancer was once the leading cause of cancer death for women in the United States. It's much less common today, mainly because of the availability of the Pap test and the human papillomavirus (HPV) vaccine.
According to the Centers for Disease Control and Prevention (CDC), the Pap test can find cervical cancer early, when it’s most treatable. It can also alert doctors to changes in the cervix that occur before any cancer develops. Additionally, the HPV vaccine can prevent infection with the virus, which is the cause of nearly all forms of cervical cancer.
The American Cancer Society (ACS) estimates that there are over 12,000 new cases of cervical cancer every year and over 4,000 deaths from it. This is why the ACS recommends that all women ages 21 to 65 get Pap tests, either every three years or, combined with an HPV test, every five years.
During a Pap test, a sample of cells is taken from the cervix and the cervical canal. The sample is tested and will be either negative or positive. Negative results mean that no cell abnormalities were detected. Positive results mean that abnormal cells were seen in the sample. Positive results can be confusing. They are explained below.
The word squamous means “plate-like” or “scaly” and refers to squamous cells. These are the relatively flat cells that make up the outer layers of the cervix. According to the ACS, SIL is further categorized as either low grade or high grade.
Low-grade SIL (LSIL) indicates mild changes to the cells (dysplasia) that might resolve without treatment but could lead to more ominous precancerous changes. High-grade SIL (HSIL) indicates changes that are likely to become cancerous without treatment. High-grade lesions are determined to represent moderate dysplasia, severe dysplasia, or carcinoma in situ (CIS or noninvasive cancer).
These designations are part of the Bethesda system of classification and are used to describe abnormal Pap test results.
Intraepithelial neoplasia refers to the new formation of a lesion within the cervical tissue. According to the ACS, the lesion, or tumor, will be labeled as follows:
- CIN 1 for mild dysplasia
- CIN 2 for moderate dysplasia
- CIN 3 for severe dysplasia or CIS
It’s important to note that CIN is not cancer. It only designates the presence of abnormal cells. If discovered early enough, it can be treated.
If your doctor determines that you do have cervical cancer, the next step will be to determine whether the cancer has spread. This process is known as staging. Physicians use one of two classification systems. The first is the FIGO system. The other, which is more common in the United States, is the American Joint Committee on Cancer’s TNM system.
The TNM system assigns a stage from 0 to 4 to indicate the general state of the cancer, and adds additional letters and numbers to indicate specific features of the tumor. Number-letter combinations with the letter T indicate the extent of the tumor. Number-letter combinations with the letter N indicate if the cancer has spread to nearby lymph nodes. Number letter combinations with the letter M indicate if the cancer has spread (metastasized) to any distant parts of the body.