TY - CHAP M1 - Book, Section TI - Cervical Cancer A1 - Dooley-Hash, Suzanne A1 - Knoop, Kevin J. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason PY - 2021 T2 - The Atlas of Emergency Medicine, 5e AB - Cervical cancer was once one of the most common causes of death from cancer in US women; however, deaths have decreased significantly with the use of routine Pap smears, which can detect precancerous changes and prompt early treatment. It is most commonly diagnosed between the ages of 35 and 44, but risk increases with age, and more than 15% of new cases are in women older than age 65. It is rare in women younger than 20. Squamous cell carcinoma accounts for 90% of cases, with adenocarcinoma being the second most common. Risk factors include infection with human papillomavirus (HPV), smoking, chlamydial infections, immunosuppression, intrauterine device (IUD) use, family history, multiple full-term pregnancies, early age at 1st pregnancy, and long-term oral contraceptive use. Most cervical cancer or precancerous lesions are found incidentally or during routine gynecologic exam. More advanced cases may present with pelvic discomfort, vaginal bleeding or discharge, bleeding after intercourse, and dyspareunia. Speculum examination with careful visual inspection of the cervix is key to identification. Definitive diagnosis is made by biopsy. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181041633 ER -