The staging system of cervical cancer helps determine the tumor’s location and its metastasis. The staging system formed by the International Federation of Obstetrics and Gynecology is used for cervical cancer. Staging is the conclusion of a physical exam, biopsies, and imaging scans. A total of four stages of cervical cancer are diagnosed. The stages of cervical cancer ranges from stage I (IA-IA1, IA2; IB- IB1, IB2, IB3), stage II (IIA- IIA1, IIA2; IIB), stage III (IIIA, IIIB, IIIC-IIIC1, IIIC2), and stage IV (IVA, IVB).
Staging System of Cervical Cancer
Staging is the procedure of determining where the tumor is located, whether it has spread or not, and how it grows. While assessing the stages of cervical cancer, many factors are taken into account.
Doctors use diagnostic tests to discover cervical cancer stages, so staging may not be complete until all tests are finished.
The staging system formed by the International Federation of Obstetrics and Gynecology is used for cervical cancer.
Staging is based on the conclusions of a physical exam, biopsies, and imaging scans 1.
Stage I: Cancer has spread from the cervix lining into the deeper tissue but is just found in the uterus. It has not grown to other parts of the body. This stage of cervical cancer may be divided into sub-groups to describe cancer in more detail.
- Stage IA – The cancer is diagnosed only by seeing cervical cells or tissues under a microscope. Evaluation of tissue samples or imaging tests can also determine tumor size.
- Stage IA1: A cancerous area of less than 3 millimeters (mm) in depth.
- Stage IA2: A cancerous area is 3 mm to less than 5 mm in depth.
- Stage IB – In this stage of cervical cancer, the tumour is larger but still only confined to the cervix. There is no distant spread.
- Stage IB1: The tumour is 5 mm or more in-depth and less than 2 centimeters (cm) wide.
- Stage IB2: The tumour is 2 cm or more in-depth and less than 4 cm wide.
- Stage IB3: The tumour is 4 cm or more in width.
Stage II: Cancer has spread beyond the uterus to surrounding areas, such as the tissue near the cervix or vagina, but it is inside the pelvic area and has not spread to other parts of the body. This stage may be divided into sub-groups to describe cervical cancer in more detail.
- Stage IIA – The tumor is restricted to the upper two-thirds of the vagina. It has not spread to the tissue next to the cervix, called the parametrial area.
- Stage IIA1: The tumor is less than 4 cm wide.
- Stage IIA2: The tumor is 4 cm or more in width.
- Stage IIB – The tumor has spread to the parametrial area. The tumor does not reach the pelvic wall.
Stage III: In this stage of cervical cancer the tumor involves the lower third of the vagina or has spread to the pelvic wall, leading to kidney swelling, called hydronephrosis; stop a kidney from functioning, or includes regional lymph nodes 2. Lymph nodes are bean-shaped small organs that help fight against infection. There is no distant spread.
- Stage IIIA- The tumour involves the lower third of the vagina, but it has not grown into the pelvic wall.
- Stage IIIB- The tumour has grown into the pelvic wall or affects a kidney.
- Stage IIIC – The tumour includes regional lymph nodes. This can be found using pathology or imaging tests. Adding a lowercase ‘r’ indicates imaging tests were used to confirm lymph node involvement. A lowercase ‘p’ means pathology results were used to determine the stage.
- Stage IIIC1 – Cancer has spread to lymph nodes in the pelvis.
- Stage IIIC2 – Cancer has spread to para-aortic lymph nodes found in the abdomen near the base of the spine and near the aorta (a major artery that runs from the heart to the abdomen).
Stage IVA – In this stage of cervical cancer the cancer has spread to the bladder or rectum, but it has not spread to other parts of the body.
Stage IVB – cancer has spread to other parts of the body.
- 1.Matsuo K, Machida H, Mandelbaum RS, Konishi I, Mikami M. Validation of the 2018 FIGO cervical cancer staging system. Gynecologic Oncology. Published online January 2019:87-93. doi:10.1016/j.ygyno.2018.10.026
- 2.Liu X, Wang J, Hu K, et al. <p>Validation of the 2018 FIGO Staging System of Cervical Cancer for Stage III Patients with a Cohort from China</p> CMAR. Published online February 2020:1405-1410. doi:10.2147/cmar.s239624