The diagnosis may be made by the microscopic examination of the discharge and of excised tissue.
Complete hysterectomy should be performed for tuberculosis of the cervix.
Cancer of the cervix uteri is a very common disease. About one-third of all cases of cancer in women affect the uterus. Like cancer in other parts of the body, the disease has been observed at almost every period of life except infancy. It occurs most frequently during the active mature life of the woman, between the ages of thirty and fifty. It is probable that more cases occur during the latter decade of this period than during the former.
Cancer of the cervix is a disease of the childbearing woman. It is very rare in women who have never conceived. Statistics show that women who develop cancer of the cervix have borne on an average five children. The stout, well-nourished mother of a large family is very prone to cancer of the cervix.
It is probable that the chief predisposing cause of cancer of the cervix is a fissure or laceration caused by miscarriage or labor. A focus of irritation, an area of diminished resistance, is thus developed, where cancer may start in a woman predisposed to this disease. In some of the cases of cancer of the cervix occurring in sterile women it has been found that previous traumatism had been inflicted by dilatation or incision of the cervix.
Cancer of the cervix uteri originates in one of three structures: I. The squamous epithelium covering the vaginal aspect of the cervix; II. The cylindrical cells lining the cervical canal; III. The epithelial cells of the cervical glands. The first variety is called squamous-cell carcinoma of the cervix. The second and third varieties are called adeno-carcinoma of the cervix.
The early appearance of the disease, the gross form assumed by the cancer, the direction of growth, and the clinical course depend upon the place of origin. In the late stages of the disease, characterized by extensive destruction of tissue, all forms appear alike.
I. Cancer of the vaginal aspect of the cervix (squamous-cell carcinoma) very often begins in a benign erosion of an old laceration. The early stages of transition from the benign to the malignant condition are not apparent to the unaided senses, and can be recognized only by the microscope. Later a superficial ulceration is developed, or the cancer may assume the polypoid or vegetating form, and become readily recognized by the unaided senses.