• cervical cancer
  • farzaneh jalili,1,*
    1. MSc of Biology-Genetics, Department of Genetics, Zanjan Branch, Islamic Azad University, Zanjan, Iran


  • Introduction: Cervical cancer is the fourth common gynecological malignancy disorders and second leading cause of cancer associated female mortality in many less developed countries. The disease is most commonly diagnosed in the fifth decade of life several years earlier than medien age at diagnosis of breast , lung and ovarian cancers . the main causes are repeated contact with high risk hpv virus( which is transmitted through sex), weak immune system and smoking .many of high risk hpv types can cause anogenital cancers . between high risk hpv types that cause anogenital cancer ,types 16,18,31,35,39,45,51,52,56,58 cause most invasive cancers.cerviacal cancer is characterized by symptoms of bleeding after intercourses, abnormal bleeding between periods , chronic pelvic pains, and a feeling of pelvic pressure .According to figo classification cervical cancer is classified into following groups :stage 0:carcinum in sito , stage 1:invasive carcinoma strictly confined to cervix, stage 2:carcinoma extending beyond cervix but not to pelvic sidewall, stage 3: carcinoma extending anto pelvicwall, stage4:carcinoma extends beyond the true pelvic wall or clinically involves mucosa of bladder or rectum. Treatment according to the stage of diagnosis includes hysterectomy, chemotherapy, radiotherapy or a combination of these.
  • Methods: the present literature review was performed using pubmed (national institute of health .ncbi.nlm.nih.gov/pubmed ) , scopus ( elsevier, scopus.com/scopus/home.url)and web of knowledge(thomson reuters,wok.mimas.ac.uk)electronic databases,and the following key words were searched:cervical cancer, epigenetic changes in cervical cancer . several article were found in the surveyed databases and only the most relevant ones published in high impact factor journals and conducted by groups with recognized knowledge in the area were selected .
  • Results: cervical cancer can develop in about 500000 women in year. Recent studies have shown the correlation between epigenetics and development and progression of cervical cancer. Among the epigenetic modifications, the role of candidate gene DNA methylation in cervical cancer has been studied the most. Accumulated DNA methylation in specific genes is detected as early signatures of malignant cervical cancer . High-risk HPV viruses , especially types 16 and 18, are responsible for these cell changes or dysplasia , especially in 80% squamous cells and less in 20% cylindrical cells of the cervix. . Cervical cell dysplasia is divided into three degrees before cervical cancer. Dysplasia type 1 or cin 1, which is called mild dysplasia, is improved in most cases with expectant treatment or freezing. Dysplasia type 2 or CIN 2, which has involved two thirds of the cervix, treatment includes colposcopy or biopsy of the changed tissue seen in colposcopy in terms of transformation and visualization of cancerous cells or loop or conization or cone removal or cold knife to remove the changed tissue In case of no improvement . expectant treatment like , pap smear and vaginal exam should be repeated every six months for two years, and in case of no improvement or progress to the third stage or CIN 3, where three quarters of the cervix is involved, the treatment includes removal of the lesion or hysterectomy in the operating room at an advanced age.
  • Conclusion: Cervical cancer, although after breast and ovarian cancer, threatens the health of women of reproductive age, but by performing a series of diagnostic tests such as a pap smear from the age of twenty, if sexual activity begins,once a year for three years, and if the pap smear is normal,repeated every three years. and from the age of 30, performing HPV typing along with Pap smear every five years, as well as avoiding high-risk behaviors such as multiple sexual partners, not using condoms, and smoking can be diagnosed, prevented, and treated.
  • Keywords: cervical cancer, epigenetic, methylation, cin, pap amear