Cervical cancer is typically staged using the International Federation of Gynecologists and Obstetricians (FIGO) system. This staging system is based on clinical examination and not surgical findings. Several diagnostic tests are used to stage the disease, including palpation, inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, x-ray examination of the lungs and skeleton, and cervical conization.
The FIGO system consists of the following stages of cervical cancer:
- Stage I: Confined to cervix uteri (extension to the corpus should be disregarded)
- Stage IA: invasive carcinoma only diagnosed by microscopy
- Stage IA1: stromal invasion <3 mm in depth
- Stage IA2: stromal invasion ≥3 mm and <5 mm in depth
- Stage IB: invasive carcinoma with measured deepest invasion ≥5 mm (greater than stage IA), lesion limited to the cervix uteri
- Stage IB1: invasive carcinoma ≥5 mm depth of stromal invasion and <2 cm in greatest dimension
- Stage IB2: invasive carcinoma ≥2 cm and <4 cm in greatest dimension
- Stage IB3: invasive carcinoma ≥4 cm in greatest dimension
- Stage II: beyond the uterus, but has not extended onto the lower third of the vagina or to the pelvic wall
- Stage IIA: involvement limited to the upper 2/3 of vagina without parametrial invasion
- Stage IIA1: invasive carcinoma <4 cm in greatest dimension
- Stage IIA2: invasive carcinoma ≥4 cm in greatest dimension
- Stage IIB: with parametrial involvement but not up to the pelvic wall
- Stage III: carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or non‐functioning kidney and/or involves pelvic and/or paraaortic lymph nodes
- Stage IIIA: carcinoma involves the lower third of the vagina, with no extension to the pelvic wall
- Stage IIIB: extension to the pelvic wall and/or hydronephrosis or non‐functioning kidney (unless known to be due to another cause)
- Stage IIIC: involvement of pelvic and/or para-aortic lymph nodes, irrespective of tumor size and extent
- Stage IIIC1: pelvic lymph node metastasis only
- Stage IIIC2: para-aortic lymph node metastasis
- Stage IV: carcinoma has extended beyond the true pelvis or has involved (biopsy-proven) the mucosa of the bladder or rectum (bullous edema, as such, does not permit a case to be allotted to stage IV)
- Stage IVA: spread to adjacent organs
- Stage IVB: spread to distant organs such as the lungs
