A human papillomavirus (HPV)-related malignancy, preventable by HPV vaccination, screening, and treatment of high-grade dysplasia.
Cervical cancer screening by cytology (Pap testing) alone, Pap and HPV co-testing, or primary HPV testing may detect pre-invasive disease.
Patients are commonly asymptomatic at presentation, and identified following screening. Patients with advanced disease may present with symptoms such as abnormal vaginal bleeding, postcoital bleeding, vaginal discharge, pelvic or back pain, dyspareunia, or obstructive uropathy.
Staging using International Federation of Gynecology and Obstetrics (FIGO) criteria is based on clinical assessment only. When available, advanced imaging modalities (MRI, PET, PET/CT, CT) are used to evaluate the local extent of disease and to screen for metastases, which may guide treatment planning.
For microinvasive disease, treatment with conization is recommended.
For early stage invasive disease, surgery is recommended.
For locally advanced disease, chemoradiation therapy is significantly superior to radiation therapy alone.
Cervical cancer is a human papillomavirus-related malignancy of the uterine cervical mucosa.
History and exam
- human papillomavirus (HPV) infection
- age group
- HIV infection
- early onset of sexual activity (younger than 18)
- multiple sexual partners
- cigarette smoking
- history of STI
- oral contraceptive pill use
- high parity
- uncircumcised male partner
- micronutrient malnutrition
- low serum folate
- low vitamin C and E levels
- alcohol abuse
- low socioeconomic status
Medical Gynecologic Oncology
Division of Hematology Oncology
Massachusetts General Hospital
RTP is a paid participant in scientific advisory boards for Genentech, Roche, and Merck. RTP is an author of a number of references cited in this topic.
Department of Radiation Oncology
Brigham and Women’s Hospital
LJL receives research funding from the Koch Institute at the Massachusetts Institute of Technology and the Dana-Farber Cancer Institute. LJL is also the principal investigator of an immunotherapy and radiation trial sponsored by AstraZeneca.
Dr Richard T. Penson and Dr Larissa J. Lee would like to gratefully acknowledge Dr Neil S. Horowitz and Dr Anthony H. Russell, previous contributors to this topic.
NSH and AHR declare that they have no competing interests.
Minimally Invasive Gynecologic Surgery
Magee Women's Hospital
University of Pittsburgh Medical Center
LY declares that she has no competing interests.
Consultant in Obstetrics & Gynaecology
Lead Clinician in Colposcopy
Imperial College Healthcare NHS Trust
DL declares that she has no competing interests.
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