Diagnosis and management of cervical cancer

Cervical cancer is the second most common cancer in women worldwide, with more than half a million new cases diagnosed in 2005.1 The disease disproportionately affects the poorest regions—more than 80% of cases are found in developing nations, mainly in Latin America, sub-Saharan Africa, and the Indian subcontinent.1 Cervical cancer is an important cause of early loss of life as it affects relatively young women. Important advances have taken place in the diagnosis and treatment of this cancer in recent years. Surgery or chemoradiotherapy can cure 80-95% of women with early stage disease (stages I and II) and 60% with stage III disease (table⇓).2 3 4 5 View this table: International Federation of Gynaecology and Obstetrics (FIGO) staging classification (FIGO 1995, Montreal): cervical carcinoma #### Summary points We searched the literature to identify all relevant articles published from 1966 to March 2007 (PubMed and Cochrane database) using a combination of the terms “cervical cancer”, “diagnosis”, and “management”. Variables of interest were cervical cancer, surgery, chemotherapy, radiotherapy, chemoradiotherapy, complications of treatment, recurrence, and follow-up. Much of the clinical management discussed in this review was based on meta-analyses, systematic reviews, and phase III randomised controlled trials (RCTs). Infection with high risk types of human papillomavirus is the main cause of cervical cancer.6 This has obvious implications for primary prevention (vaccination) and secondary …