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Staging of Cervical Cancer

Cervical cancer is typically staged by using the International Federation of Gynecologists and Obstetricians (FIGO) system. This staging system is based on clinical examination and not surgical findings. Several diagnostic tests are used to stage the disease and include palpation, inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, x-ray examination of the lungs and skeleton, and cervical conization.

The FIGO system consists of the following stages for cervical cancer:

  • Stage 0: Carcinoma in situ; non-invasive cancer that is confined to the layer of cells lining the cervix
  • Stage I: Cancer that has spread into the connective tissue of the cervix but is confined to the uterus
  • Stage IA: Very small cancerous area that is visible only with a microscope
  • Stage IA1: Invasion area is less than 3 mm (0.13 in) deep and 7 mm (0.33 in) wide
  • Stage IA2: Invasion area is 3-5 mm (0.13-0.2 in) deep and less than 7 mm (0.33 in) wide
  • Stage IB: Cancer can be seen without a microscope or is deeper than 5 mm (0.2 in) or wider than 7 mm (0.33 in)
  • Stage IB1: Cancer is no larger than 4 cm (1.6 in)
  • Stage IB2: Stage IB cancer is larger than 4 cm (1.6 in)
  • Stage II: Cancer has spread from the cervix but is confined to the pelvic region
  • Stage IIA: Cancer has spread to the upper region of the vagina but not to the lower one-third of the vagina
  • Stage IIB: Cancer has spread to the parametrial tissue adjacent to the cervix
  • Stage III: Cancer has spread to the lower one-third of the vagina or to the wall of the pelvis and may be blocking the ureters
  • Stage IIIA: Cancer has spread to the lower vagina but not to the pelvic wall
  • Stage IIIB: Cancer has spread to the pelvic wall and/or is blocking the flow of urine through the ureters to the bladder
  • Stage IV: Cancer has spread to other parts of the body
  • Stage IVA: Cancer has spread to the bladder or rectum
  • Stage IVB: Cancer has spread to distant organs such as the lungs
  • Recurrent: Following treatment, cancer has returned to the cervix or some other part of the body