Stages of Cervical Cancer from Stage O to Stage IV

Stage 0, Stage I, Stage II, Stage III, and Stage IV Cervical Cancer

Pelvic Exam
Pelvic Exam. Sean Gallup / Staff / Getty Images

What are the stages of cervical cancer?  What does my stage of the disease mean?

Stages of Cervical Cancer

Cervical cancer, like many cancers, is divided into stages based on how large a cancer is and how far it has spread.  Staging is one of the most important factors in determining the right treatment for a cancer, and an accurate determination of stage is therefore a high priority when someone is first diagnosed with the disease.

  Staging is also a way in which doctors can predict prognosis - or how well someone is expected to do with treatment.

The system most commonly used with cervical cancer is referred to the Figo system which stands for International Federation of Gynecology and Obstetrics.

In addition to stages, most of these stages have a sub-stage, further breaking down the differences between cancers and helping to select treatments.  These stages go from stage 0 which is a non-invasive cancer, up to stage IV, which is considered a metastatic cancer.

Stage 0 Cervical Cancer

Also called carcinoma in situ, stage 0 means that cancerous cells are found only on the lining of the cervix and have not invaded deeper tissues.  This stage of cancer is considered non-invasive, with any stage beyond stage 0 considered invasive.  There has been much debate over whether this is truly cancer or is rather a precancerous stage.

Stage I

In stage I, cancer cells are only present in the cervix and have not traveled elsewhere.  The cancerous cells have invaded the cervix, and cells are no longer just at the surface. This stage is broken down into:

Stage IA - Stage IA is the earliest stage of invasive cervical cancer.  The cancer cannot yet be visualized with the naked eye and can only be identified under the microscope.

  This stage is further broken down by size into:

  • Stage IA1 - The invasion area is not more than 3 mm deep and not more than 7 mm wide.
  • Stage IA2 - The invasion area is greater than 3 mm but not more than 5 mm deep, and not more than 7 mm wide.

Stage IB - This stage includes tumors that are slightly larger than stage IA and may or not be visible without a microscope

  • Stage IB1 - These tumors can only be seen under the microscope.  The invasion is not more than 5 mm deep and not more than 7 mm wide, or they can be seen under the microscope but are less than 4 cm in size.
  • Stage IB2 - These tumors can be seen without a microscope and are larger than 4 cm in size.

Stage II Cervical Cancer

In stage II cervical cancer, cells have spread beyond the cervix but have not spread to the pelvic wall or the the lower third of the vagina.

Stage IIA - These cancers have spread beyond the cervix to the upper 2/3 of the vagina, but have not spread around the uterus.  This is further broken down by size into:

  • Stage IIA1 - The tumor can be seen without a microscope but is not more than 4 cm in size.
  • Stage IIA2 - The tumor can be seen without a microscope and is more than 4 cm in size.

Stage IIB - The cancer has spread to the tissues around the uterus and the upper 2/3 of the vagina, but not to the pelvic wall.

Stage III Cervical Cancer

In stage III, in addition to spread as noted above to the upper 2/3 of the vagina and to the tissues around the uterus, these cancers may have spread to the lower 1/3 of the vagina, to the pelvic wall, and/or may involve the kidneys.  This is further broken down by spread into:

Stage IIIA - These cancers may have spread to the lower 1/3 of the vagina, but not to the pelvic wall.

Stage IIIB - There are a few reasons why a cervical cancer would be classified as stage IIIB.  One is if it has invaded the pelvic wall.  The other is if it has blocked one or both ureters (the tubes which travel from the kidney to the bladder) such that it has caused the kidneys to become enlarged or stop working as well as usual.

Stage IV Cervical Cancer

In stage IV cervical cancer the tumor has spread beyond the region of the cervix to involve the wall of the bladder or rectum or has spread to other regions of the body.

Stage IVA - These cancers have spread so that they have invaded either the bladder or rectum or both (spread to adjacent pelvic organs.)

Stage IVB - These cancers have spread to distant regions of the body, for example, lymph nodes in a distant region of the body, or the lungs, liver, or bones.

Next Steps

Now that you are familiar with the stages of cervical cancer, what are the treatment options?

If, instead, you are just learning about cervical cancer, make sure to learn about way of preventing cervical cancer, as well as who should get the cervical cancer vaccine.  And make sure you are familiar with the symptoms of cervical cancer - even if you get the shot.

Sources:

National Cancer Institute. Cervical Cancer Treatment – Health Professional Version (PDQ). Updated 02/04/16. http://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq

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