Criteria for TNM Clinical Staging: Standard clinical staging for cervical carcinoma is that which is available at any community hospital. This includes physical examination and history, palpation of abdomen and pelvis, endocervical curettage, colposcopy, cystoscopy, proctoscopy, intravenous urography, hysteroscopy and imaging of the abdomen, lungs and bones. Additional procedures, such as laparoscopy, lymphangiography, venography and arteriography may better define the extent of the cancer, but should not influence staging.

Criteria for TNM Pathologic Staging: Pathologic review of resected specimens adds detailed staging information to the case, but should be recorded separately and should not be used to change the clinical staging.

Clinical staging is the preferred staging for cervical cancer. The clinical staging of cervical cancer should never be changed based on additional findings at surgery or later clinical findings.

Staging for cervical tumors applies only to carcinomas, not to sarcomas or other histologies.

AJCC FIGO Definition
Tis 0 In situ
T1 I Confined to uterus
T1a IA Diagnosed only by microscopy
T1a1 IA1 Depth = < 3 mm, horizontal spread = < 7 mm
T1a2 IA2 Depth > 3 to 5 mm, horizontal spread = < 7 mm
T1b IB Clinically visible or microscopic lesion, greater than T1a2
T1b1 IB1 = < 4 cm
T1b2 IB2 > 4 cm
T2 II Beyond uterus but not pelvic wall or lower third of vagina
T2a IIA No parametrial involvement
T2b IIB Parametrial involvement
T3 III Lower third of vagina or pelvic wall or hydronephrosis
T3a IIIA Lower third of vagina
T3b IIIB Pelvic wall/hydronephrosis
T4 IVA Mucosa of bladder or rectum; beyond true pelvis
M1 IVB Distant metastasis

Collaborative Stage Elements

For more details on Collaborative Stage, see the Intro to Collaborative Staging module.