2.  Cervical cancer is a malignant tumour deriving from cells of the "cervix uteri", which is the lower part of uterus.  Begins in the lining of the cervix  Cells change from normal to pre-cancer (dysplasia) and then to cancer

3.  Lower part of the uterus  Connects the body of the uterus to the vagina

4.  Affects 16/ 100000 women  14-24% of all female cancer

5.  Human papilloma virus Infection with the common human papillomavirus (HPV) is a cause of approximately 90% of all cervical cancers. About half of the sexually transmitted HPVs are associated with cervical cancer.

6. Sexual History A woman has a higher-than-average risk of developing cervical cancer if she:  Has had multiple sexual partners  Began having sexual relations before the age of 18  Has a partner who has had sexual contact with a woman with cervical cancer

7.  HIV infection  Chlamydia infection  Low socioeconomic status  Smoking  Several pregnancies  Giving birth at a very young age  Long-term use of the contraceptive pill  Family history

8.  Intermenstrual Bleeding  Bleeding after sexual intercourse or a pelvic exam  longer and are heavier menstrual periods  Bleeding after menopause  Increased vaginal discharge: offensive  Pelvic pain, back pain and leg pain  Bladder symptoms: frequency, dysuria, haematuria, fistula  Rectal symptoms: diarrhoea, bleeding, fistula

9.  PAP SMEAR  HPV DNA test  COLPOSCOPY  CERVICAL BIOPSY  CYSTOSCOPY, CHEST X RAY, IVP, PROCTOSCOPY (for staging)  CT scan  MRI

10. Routine screening for cervical abnormalities

11.  Like the Pap test, the HPV DNA test involves collecting cells from the cervix for lab testing. HPV DNA test

12. A visual examination of the surface of the cervix using a colposcope- an instrument with magnifying lenses and a light. If abnormalities are seen, a tissue sample (biopsy) may be taken and sent for evaluation.

14.  Stage 0: cancer insitu  Stage I. Cancer is confined to the cervix.  Stage II. Cancer at this stage includes the cervix and uterus, but hasn't spread to the pelvic wall or the lower portion of the vagina.  Stage III. Cancer at this stage has moved beyond the cervix and uterus to the pelvic wall or the lower portion of the vagina.  Stage IV. At this stage, cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other areas of the body, such as the lungs, liver or bones.

16.  Chemotherapy Chemotherapy is the use of chemicals (medication) to destroy cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing (Cisplatin)  Radiotherapy For patients with advanced cervical cancer radiation combined cisplatin-based chemotherapy is the most effective treatment

17.  Laser surgery - a narrow beam of intense light destroys cancerous and precancerous cells.  LEEP (loop electrical excision procedure) - a wire loop which has an electric current cuts through tissue removing cells from the mouth of the cervix.

19.  Simple hysterectomy Removal of the body of the uterus and cervix.  Radical hysterectomy and pelvic lymph node dissection Removal of entire uterus, surrounding tissue, upper part of the vagina, and lymph nodes

20.  HPV vaccine  Safe sex  Cervical screening: pap smear  Have few sexual partners  Delay first sexual intercourse  Don't smoke