Cervical Cancer Diagnosis

The primary cause of cervical cancer is infection with certain types of human papillomavirus (HPV). Importantly HPV infections are common in healthy women and only rarely result in cervical cancer. Persistence of HPV infection and progression to cancer may be influenced by many factors, such as immunosuppression, high parity (number of childbirths), and cigarette smoking.

Early cancers of the cervix can be found by a Pap test; a relatively painless, simple procedure that should be performed annually for women over the age of 18. This test collects cells from the cervix and examines them under a microscope to look for evidence of cancer. Survival for patients with an early pre-invasive lesion is nearly 100%, with curative treatment possible through local procedures. Of particular interest is that the PET/CT findings at presentation of cervical cancer are predictive of disease-free recurrence. Patients with positive PET and CT scans of the retroperitoneal nodes have the worst prognosis. Patients with positive PET and negative CT scans have nearly as poor a prognosis, whereas patients with negative PET scans of these nodes, irrespective of CT findings, have a substantially better prognosis.¹

When cervical cancer has not been found at this pre-invasive stage, tests are performed to determine if and how far the cancer has spread. If lymph nodes are involved with disease, the cancer may have spread systemically. PET/CT imaging increases the accuracy for detecting lymph node and metastatic disease in patients with advanced-stage cervical cancer.²

Early determination of how far the invasive cervical cancer has spread is key to selecting the most appropriate treatment.

Grigsby PW et al, Lymph node staging by positron emission tomography in patients with carcinoma of the cervix. J Clin Oncol; 19:3745-3749

Shih-Ya M, et al. Delayed 18F-FDG PET for Detection of Paraaortic Lymph Node Metastases in Cervical Cancer Patients. J Nucl Med 2003; 44(11):1775-1783