CERVICAL CANCER Definisi Ca servix merupakan keganasan yang terjadi pada serviks uterus, yaitu suatu daerah pada

organ reproduksi wanita yang merupakan pintu masuk ke arah rahim. Epidemiologi Kanker cerviks merupakan urutan kedua keganasan yang sering terjadi pada wanita diseluruh dunia. Angka kejadian penyakit ini terus naik pada negara- negara berkembang. Di US angka kejadian kanker cerviks berkurang, hal ini disebabkan karena dijalankannya skrining massa dengan test papanicolaou. US, 2004- 2006 melaporan bahwa kejadian insidensi kanker servix stage akhir tinggi pada wanita usia 50-79 tahun dan hispanik. Pada tahun 2002, perkiraan kasus baru 493.000 diidentifikasi diseluruh dunia dan dilaporkan 274.000 kematian. Secara umum, insiden yang tinggi ditemukan pada negara berkembang. Di US, kanker servix adalah kanker ginekologi tersering ke 3(jemal, 2006). Di US wanita memiliki resiko 1 dari 135 untuk terkena kanker ini. Pada tahun2006, the American Cancer Society memperkirakan 9.710 kasus baru dan 3.700 kematian karena keganasan ini (Parkin,2005).

Staging Table 30-6 Clinical Stages of Cervical Cancer (FIGO, Revised 1994) Stage Characteristics 0 I IA Carcinoma in situ, cervical intraepithelial lesion (CIN) 3 Carcinoma is strictly confined to cervix (extension to corpus should be disregarded) Invasion is limited to measured stromal invasion with a maximum depth of 5 mm and no wider than 7mm Measured invasion of stroma no greater than 3 mm in depth and no wider than 7 mm IA1 Measured invasion of stroma greater than 3 mm and no greater than 5 mm in depth IA2 IB IB1 Clinical lesions greater than 4 cm in size IB2 II IIA IIB III Carcinoma extends beyond cervix but has not extended to pelvic wall; it involves vagina, but not as far as the lower third No obvious parametrial involvement Obvious parametrial involvement Carcinoma has extended to the pelvic wall; on rectal examination there is no cancerfree space between tumor and pelvic wall; tumor involves lower third of vagina; all cases with hydronephrosis or nonfunctioning kidney should be included, unless they are known to be due to another cause IIIA IIIB IV No extension to pelvic wall, but involvement of lower third of vagina Extension to pelvic wall, or hydronephrosis or nonfunctioning kidney due to tumor Carcinoma has extended beyond true pelvis or has clinically involved mucosa of bladder or rectum IVA Spread of growth to adjacent pelvic organs IVB Spread to distant organs and no wider than 7mm Clinical lesions confined to the cervix or preclinical lesions greater than IA Clinical lesions no greater than 4 cm in size

Kriteria Diagnostik