Lesions of the cervix

1. Big picture

Cervical lesions range from benign visible changes to HPV-related precancer and invasive cervical cancer. In the exam, approach the cervix clinically:

Visible cervical lesion
→ benign-looking or suspicious?
→ symptomatic: discharge, contact bleeding, postcoital bleeding, pelvic pain?
→ pregnancy status?
→ infection, polyp, ectropion, CIN, or invasive cancer?
→ cytology/HPV test is screening; biopsy gives diagnosis

The examiner wants you to understand that the cervix has a special vulnerable area: the transformation zone, where squamous metaplasia occurs and where most cervical intraepithelial neoplasia (CIN) and cervical cancers develop.