Carcinoma of the uterine cervix in pregnancy: A study of the incidence and treatment in the Western region of Sweden 1973 to 1992

Abstract

OBJECTIVE: To review the incidence, treatment and outcome of cervical cancer during pregnancy in the Western region of Sweden. METHODS: Population based data on cervical cancer during pregnancy were collected from 1973 to 1992. RESULTS: Cervical carcinoma was diagnosed in 33 women in association with pregnancy, giving an incidence of 11.1 cases per 100,000 deliveries and 7.5 cases per 100,000 pregnancies. Pregnancy complicated one of every 55 cases of invasive carcinoma. Twelve women were in the 3rd trimester and nine women were post partum. Abnormal bleeding was the symptom that led to examination and diagnosis in 54.5% of the women and 45.5% of the women were asymptomatic but had an abnormal cervico-vaginal cytological test (39.4%) or abnormal finding at vaginal examination (6.1%) in association with pregnancy. In the 1st-2nd trimester all but one woman and in the 3rd trimester all but two women, had a stage I carcinoma. Post partum five women were in stage I, three women were in stage II and one woman had a stage III carcinoma. Histology revealed squamous cell carcinoma in 29 women, adenocarcinoma in three women and adenosquamous carcinoma in one woman. During the follow up period 1/12 women in the 1st trimester, 4/12 in the 3rd trimester and 2/9 women post partum have died of disease. CONCLUSION: During the years of this study different modalities of treatment were used, with a change from primary radiation to primary surgery.