Cervical Cancer

Alisya Nurulita E.P

1510211160
• The second biggest cause of female cancer mortality worldwide with 288,000 deaths
yearly.
• Ranks as the 3rd most frequent cancer among women in Indonesia,
• The 2nd most frequent cancer among women between 15 and 44 years of age.
• Every year more than 13,500 women are diagnosed with cervical cancer, almost 7,500 die
from the disease.
Risk factor
Early menarche

Gbr : Schorge J, Hoffman B, Bradshaw K, Halvorson L, Schaffer J, Corton M. Williams gynecology. 3rd ed. United States;p.650-58
 Etiology
It is now well established that HPV (human papillomavirus) infection is
the necessary cause of cervical cancer and its immediate precursor
cervical intraepithelial neoplasia.

HPV
LR HR
Type 6 & 11 Type 16,18, 45

Condiloma acuminata Cervical Cancer

Verruca vulgaris (woman)
Laryngeal papilloma
 + Multisex partner
Early coitus
Risk Factor
Dietary deficiency
Smoking Immunosuppression Multipara
(man/woman)
Cervicitis No vaccination Hormonal contraception
Exposure Cell injury Low immune response Cervical intraepithelial neoplasia

HPV Invasion

Precancer lesion
IVA Test
Inadequate screening
Pap Smear

Cervical cancer
 ANAMNESIS DAN PF
Anamnesis Pem. Fisik

• Tahap awal >> • Dengan spekulum

Asimtomatik • Lesi prakanker dan
• Bercak darah pasca mikroinvasif >>
coitus intermittent serviks terlihat
• Cairan pervaginum normal
berbau busuk • Karsinoma: jaringan
• Tahap lanjut >> papiler, cairan
nyeri pelvis, frek berdarah, purulent,
berkemih dan BAB lesi polypoid
meningkat, weight
loss, obstruksisaluran
kemih
 IVA (VISUAL INSPECTION W/ ACETIC ACID)
IVA positif
Asam asetat 3-
5%
Acetowhite
Murah, mudah opaque
Metaplasia imatur
Tidak melihat
secara selular Dekat squamous
columnar
junction

Margin lesi
tegas
 PAPANICOLAOU
SMEAR
Tiap tahun untuk wanita 30-
50 tahun
Bila sudah 3 kali pap smear
>> 3 tahun sekali
Wanita risiko tinggi >> tiap
tahun
Swab mukosa
Sensitivitas 30-50%
Secara signifikan menurunkan
insidensi dan mortalitas
kanker serviks
STADIUM MENURUT FIGO (THE INTERNATIONAL
FEDERATION OF GYNECOLOGY AND OBSTETRICS)
HISTOPATOLOGI DISPLASIA EPITEL SERVIKS
KARSINOMA SKUAMOSA
DAN ADENOKARSINOMA
GUIDELINE DIAGNOSIS
 CERVICAL INTRAEPITHELIAL NEOPLASIA TREATMENT Ablasi / Eksisi
Cold-knife conization
CRYOTHERAPY

Laser Conization

loop electrosurgical excision

procedure (LEEP) conization

14
 Surgery + radiation + chemotherapy

CERVICAL CANCER TREATMENT

Local ablative or excision

Surgery :
Total/radical hysterectomy, conization

•Combined external beam radiation with

brachytherapy, or
•Radical hysterectomy with bilateral pelvic
lymphadenectomy

Surgery + radiation + chemotherapy

+ palliative
High parity and hormonal contraception... (PDF Download Available). Available from:
https://www.researchgate.net/publication/274336016_High_parity_and_hormonal
_contraception_use_as_risk_factors_for_cervical_cancer_in_East_Kalimantan
[accessed May 10 2018].
William’s
Robbins pathology
FIGO guideline