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Cervical cancer is a terrifying disease, and the fifth most deadly cancer in women. Nearly all cases are caused by infection with HPV (human papillomavirus), a sexually transmitted viral agent. HPV infection is very common among sexually active people, but some strains have been shown to trigger cervical cell alteration. These changes lead to intraepithelial neoplasia, a precancerous disorder also known as dysplasia.

The most common screening method for cervical cancer is to look for dysplastic cells by means of a Papanicolaou test (commonly referred to as a Pap smear). During a pelvic examination, cells are collected from the cervix and examined microscopically. Abnormalities detected via this examination lead to follow-up tests. Often the next step is a colposcopy, in which the cervix is examined closely with a camera and biopsies are taken of any visible abnormalities. A curettage of the endocervical canal leading into the uterus is often performed during this procedure as well.

Pathological examination of tissues obtained via colposcopy aids physicians in determining the appropriate course of treatment. A minor dysplasia usually leads only to a heightened degree of vigilance in future screenings, but severe dysplasia or any outright carcinoma will require surgical intervention. The most conservative surgery is a cone biopsy, usually LEEP (loop electrical excision procedure) but sometimes a cold knife cone instead. This procedure removes a conical section of cervix and, if the surgical margins of the tissue show no signs of involvement by dysplastic processes, is frequently considered to be a sufficient treatment for in situ (non-invasive) cancer and is preferred by patients who wish to remain fertile after treatment. An invasive carcinoma requires a hysterectomy, or removal of the entire cervix and uterus. Radiation and chemotherapy may also be necessary.

The vast majority of cervical cancers can be detected at early enough stages for treatment to be relatively simple, and the widespread use of Pap smears at regular intervals for sexually active women has had a dramatic effect on the incidence of severe cervical cancers. However, in recent years the approval of a vaccine against HPV has shown the possibility that cervical cancer may be able to be virtually eliminated within a generation.

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13y ago

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a cone biopsy is done to diagnose cervical cancer or to remove cancerous or precancerous tissue.


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