Doctors can stage cervical cancer using the FIGO system, or International Federation of Gynecology and Obstetrics. It defines the stage of cervical cancer and can help doctors plan a person’s treatment and outlook.
Cervical cancer is a type of cancer that develops in the cervix, which is the lower part of the uterus that connects to the vagina.
The International Federation of Gynecology and Obstetrics (FIGO) staging for cervical cancer is based on the cancer’s size, location, and spread. Higher stages indicate more advanced disease and a less optimistic outlook.
This article looks at the FIGO staging system and discusses a person’s outlook and treatment options.
FIGO stage I cervical cancer refers to cancer that is limited to the cervix and has not spread to nearby tissues or organs.
There are two FIGO sub-stages of stage I cervical cancer. These
- Stage IA: The cancer is in its early stage and has not spread beyond the cervix. It is only visible with a microscope. There are two subdivisions of this stage:
- Stage IA1: The cancer is less than 3 millimeters (mm) deep into the cervix.
- Stage IA2: The cancer is between 3 and 5 mm deep into the cervix.
- Stage IB: The cancer is still confined to the cervix but has invaded further than 5 mm deep. There are three subdivisions of this stage:
- Stage IB1: The cancer measures 2 centimeters (cm) or smaller.
- Stage IB2: The cancer measures between 2 and 4 cm.
- Stage IB3: The cancer measures more than 4 cm.
The outlook for a person with cervical cancer depends on several factors, including:
- the stage of the cancer
- the size and location of the tumor
- the person’s age and overall health
- type of treatment received
The 5-year relative survival rate for localized cervical cancer is
A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.
For example, if the 5-year relative survival rate is 91%, it means that a person with the condition is 91% as likely to live for 5 years as someone without the condition.
It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition is going to affect them.
In stage II cervical cancer, the cells have spread to the tissue around the uterus or the upper two-thirds of the vagina.
There are two FIGO sub-stages of stage II cervical cancer. These
- Stage IIA: Cancerous cells have spread to the upper two-thirds of the vagina. This stage is further divided into two sub-stages:
- Stage IIA1: The cancer measures under 4 cm.
- Stage IIA2: The cancer measures more than 4 cm.
- Stage IIB: Cancer cells have spread to the tissue around the uterus.
The 5-year relative survival rate is
At this stage, the cancer involves the lower third of the vagina. It may have extended to the pelvic wall or certain lymph nodes. The kidney function may also be affected.
There are three FIGO sub-stages of stage III cervical cancer. These
- Stage IIIA: The cancerous cells have spread to the lower third of the vagina but have not yet spread to the wall of the pelvis.
- Stage IIIB: The pelvic wall contains cancerous cells. In this stage, the kidneys may enlarge or stop working, and the cancerous mass may be large enough to block one or both ureters.
- Stage IIIC: This stage has two substages, depending on which lymph nodes the cancerous cells have spread to.
- Stage IIIC1: This stage involves the lymph nodes in the pelvis.
- Stage IIIC2: This stage involves abdominal lymph nodes near the aorta.
If the cancer cells have spread to nearby organs or lymph nodes, the 5-year relative survival rate is
Despite the lower survival rate, it is important to remember that every case is different. Some people may respond better to treatment than others, and factors such as the person’s overall health and response to treatment can also affect the outcome.
In this stage, the cancer has spread further than the pelvis. This stage is known as metastatic cervical cancer, as the cells are located far from the cervix. It may have spread to the bladder lining, wall of the rectum, or other distant body parts.
There are two sub-stages of stage IV cervical cancer:
- Stage IVA: The cancer cells have spread to pelvic organs like the rectum or bladder.
- Stage IVB: The cancer cells have spread from the cervix to distant parts of the body, such as the bones, distant lymph nodes, or the lungs.
The 5-year relative survival rate is around
The treatment can depend on the stage of cervical cancer.
- Conization: This involves removing a cone-shaped piece of abnormal tissue from the person’s cervix.
- Total hysterectomy: This refers to the removal of the uterus.
- A modified radical hysterectomy with a lymphadenectomy: A surgeon will remove the uterus, cervix, and upper part of the vagina. They may also remove the nearby tissues and ligaments. The surgeon will also remove the lymph nodes.
- Radical trachelectomy: This procedure involves removing the cervix, nearby tissue, and upper part of the vagina.
Doctors may also administer radiation therapy.
Stages IB and IIA
- radiation therapy combined with chemotherapy
- radiation therapy without chemotherapy
- radical hysterectomy combined with the removal of pelvic lymph nodes
- radical trachelectomy
IIB, III, and IVA
Treatment options include:
- radiation therapy alongside chemotherapy
- removal of the pelvic lymph nodes
Many people will receive a combination of internal and external radiation therapy.
The treatment approach for stage IV cervical cancer is often individualized based on the person’s specific situation.
The treatment plan may involve a multidisciplinary team of doctors and healthcare professionals. Oftentimes, it involves palliative care to improve the quality of life and make the person as comfortable as possible.
Healthcare professionals may use the FIGO staging system to classify cervical cancer based on the size of the tumor, the location, and how far it has spread.
The treatment options and the overall outlook for a person with cervical cancer depend on the stage.