Revised August 2008
There is now a vaccine which protects against 2 types of Human Papillomaviruses (HPV) that cause most cervical cancers. The vaccine is recommended for girls and women between the ages of 9 and 26 years before they come in contact with HPV. The vaccine may also benefit women who are sexually active and have not yet been infected with HPV. The vaccine prevents HPV infection but it does not get rid of it once the infection occurs.
In women who have never been infected with HPV, the vaccine:
- protects agains 7 out of 10 cases of cancer of the cervix
- is safe, very effective and has few side effects
For more information call your local Public Health Unit or speak to your family physician. You can also go to:
http://www.immunizebc.ca/default.htm or
http://www.healthlinkbc.ca/kbase/topic/detail/drug/zb1250/detail.htm
Approximate Five Year Survival by Stages
(corrected to exclude death from intercurrent disease)
It should be noted that these figures are approximations of five-year survival data collected from large numbers of patients within a given stage. Extreme caution should be used in attempting to use these data to assign prognosis in an individual case.
Cervix
| Stage I |
85% |
| Stage II |
55-60% |
| Stage III |
25-30% |
| Stage IV |
5-10% |
Common Errors in the Diagnosis and Management of Gynecologic Malignancies
- Failure to perform a complete history and physical examination.
- Over-reliance on diagnostic examinations and under-reliance on clinical suspicion and physical findings.
- Failure to perform a pelvic examination as part of the initial assessment.
Site Specific Errors
Absence of endocervical cells on the Pap smear may indicate that the squamocolumnar junction (where most carcinomas arise) has not been sampled and should alert the physician that this may be less than an adequate smear. A cytobrush may be used to obtain endocervical cells and sample the transformation zone. If a cytobrush is used immediate fixation with cytospray is necessary.
A Pap smear can be requested as "urgent" in cases when this information is required immediately because of special circumstances. In these situations the outer wrapper should have the words "Urgent" marked on it. This decreases the usual report time to less than one week from smear to report.
Visible lesions on the cervix should be biopsied or referred for immediate colposcopy. Pap smear is not a good diagnostic test for invasive cancer as bleeding and inflammation may hinder the cytopathologists' ability to read the smear.
Abnormal discharge or bleeding requires that the patient be examined. Many patients referred with a diagnosis of carcinoma of the cervix have their pelvic exams delayed because their symptoms are presumed to be due to an infection or abnormal menses.