A Review Article On Cervical Cancer

A
REVIEW
ARTICLE ON
CERVICAL
CANCER
ABSTRACT
Cervical cancer, the fourth most common cancer among
women worldwide, is caused almost entirely by human
papillomavirus (HPV). High-risk types of HPV can lead to cervical
intraepithelial lesions which, over time, can progress to cervical
cancer. In the United States and other developed countries,
most screening and early detection efforts involve HPV testing
and Papanicolaou (Pap) smears. HPV testing identifies exposure
to both low-and high-risk types of HPV, whereas Pap smears
identify abnormal cytology.
Cervical cancer is a largely preventable disease. Primary

prevention and screening are the most effective modalities for
decreasing the healthcare burden and mortality attributable to
cervical cancer. Since 2006, HPV vaccination has been available
to prevent cervical cancer. Interprofessional team members
must educate young female patients (ideally, prior to initiating
sexual activity) and their families about this highly effective
vaccine. This activity details primary prevention strategies,
screening guidelines, diagnostic evaluations, current staging,
and specific treatment modalities for invasive cervical cancer.
OBJECTIVE
Identify the risk factors, signs, and symptoms of cervical cancer,
including the role of high-risk HPV types in its development.
Apply evidence-based treatment modalities for precancerous

cervical lesions, and assess the indications, techniques, potential
complications, and follow-up care associated with these
interventions.
Select appropriate treatment modalities for invasive cervical

cancer based on patient characteristics, staging, and available
options, including surgery, radiation, and chemotherapy.
Collaborate with the interprofessional team to increase HPV

vaccination initiatives and to ensure coordinated and
comprehensive care for patients diagnosed with cervical cancer.
INTRODUCTION
Cervical cancer continues to rank among the top gynecologic
cancers worldwide. According to current data, it is ranked 14th
among all cancers and is the 4th most common cancer among
women worldwide. [1] Cervical cancer intervention focuses on
primary and secondary prevention. [2] Primary prevention and
screening are the best methods to decrease the burden of
cervical cancer and mortality.
In the United States and other developed countries, most

screening and diagnostic efforts are directed toward the early
identification of high-risk human papillomavirus (HPV) lesions
through HPV testing and Papanicolaou (Pap) smears. Although
HPV testing is not recommended in women younger than 30
years, low-risk younger women should begin screening with
Pap tests at age 21 and continue until age 65, per the United
States Preventive Services Task Force (USPSTF)
recommendations. Newer recommendations offer 3-to 5-year
intervals between screenings based on a patient's prior results
and the use of Pap and HPV cotesting [3][4]
Like many diseases and cancers, disparities exist in screening,

early diagnosis,
and timely treatment rates. Screening rates are lower in low
socioeconomic and low-resource areas with racial, ethnic, and
age variations. Studies show women with obesity and chronic
disease may have lower cervical and breast cancer screening
rates. A study of ethnic minority women in the United Kingdom
reports several barriers to screening, including lack of
awareness, fear, embarrassment, shame, and low perceived
risk. [5] Another study reviewing the barriers for Haitian
women revealed socioeconomic barriers, language barriers,
and a limited understanding of health and disease. [6] In the
United States,
cervical cancer mortality is disproportionately higher in black

women.
As cervical cancer is a sexually transmitted infection (STI), it is

preventable, and the global incidence can be reduced through
targeted education, screening, and intervention. Since 2006,
vaccination has been available for the prevention of cervical
cancer. Vaccination can improve cancer death rates in
populations with higher mortality rates and in developing
countries where resources may not be available for
routine screening
ETIOLOGY
Current literature reports that HPV is found in most sexually
active people at some point during their lifetime. There are
more than 130 types of known HPV, with 20 HPV types
identified as cancer-related. HPV exposure rates are only
known in women since men are not screened outside of

research protocols. HPV types 16 and 18 are the most common
HPV types
identified in invasive cervical cancer. Population-based HPV

prevalence studies show the greatest prevalence of high-risk
HPV occurs in adults younger than 25 years, and cervical cancer
deaths peak in middle-aged women between 40 and 50

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Cervical cancer is a largely preventable disease. Primary

Apply evidence-based treatment modalities for precancerous

Select appropriate treatment modalities for invasive cervical

Collaborate with the interprofessional team to increase HPV

In the United States and other developed countries, most

Like many diseases and cancers, disparities exist in screening,

cervical cancer mortality is disproportionately higher in black

As cervical cancer is a sexually transmitted infection (STI), it is

known in women since men are not screened outside of

identified in invasive cervical cancer. Population-based HPV

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