الفهرس 
ANATOMY OF THE UTERINE CERVIXOnly 14 pages are availabe for public view
 |  | from | 142 |  |  |
| | | from | 142 | | |
Abstract
Worldwide, cervical cancer is the second most common cancer in women (after breast cancer).The peak incidence occurs between the ages of 30 and 40 years.
The most important etiological factor is exposure to human papillomavirus, particularly types 16 and 18. The introduction of the vaccine against human papillomavirus 16 and 18 is likely to have a major impact on disease prevention.
The most common histological type is squamous cell carcinoma, which accounts for approximately two-thirds of all cervical cancer cases while adenocarcinoma accounts for 10–25% of cases.
The most widely used staging classification of cervical carcinoma is that of the FIGO staging system. It is clinical and does not rely on surgico–pathological findings. This enables uniformity of staging for all patients worldwide.
Other investigations may be supplemented such as examination under anesthesia, cystoscopy, sigmoidoscopy and intravenous urography, but these are optional and no longer mandatory under thenew revised FIGO staging system. Compared with surgical staging, FIGO clinical staging has been shown to be in accurate. The greatest difficulties in the clinical staging are the estimation of tumor size, especially if the tumor is primarily endocervical in location, the assessment of parametrial and pelvic sidewall invasion and the evaluation of lymph node and distant metastases.
Modern cross-sectional imaging plays a significant role in the evaluation of tumor size, detection of parametrial invasion and assessment of the involvement of the pelvic sidewall and adjacent organs, as well as assessment of nodal involvement and distant metastasis.
MRI is now a widely used imaging modality in the initial staging of primary cervical cancer. MRI has excellent soft-tissue contrast resolution, which exceeds that of CT and US. Consequently, MRI is significantly more valuable in the assessment of the size of the tumor, the depth of cervical invasion, and the local-regional extent of the disease. CT and MRI are approximately equivalent, and both are significantly superior to US, in the detection of enlarged lymph nodes, Thus CT and MRI are more accurate staging modalities but they are not warranted in patients with small-volume early disease (<2 cm³) because of the low probability of parametrial invasion and nodal metastasis.