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Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis

INTRODUCTION

Cancer of the uterine cervix is the third most common gynecologic cancer diagnosis and cause of death among gynecologic cancers in the United States [1]. Cervical cancer has lower rates than uterine corpus and ovarian cancer, as well as many other cancer sites. These rankings are similar to global estimates for other developed countries [2]. Unfortunately, in countries that do not have access to cervical cancer screening and prevention programs, cervical cancer remains the second most common type of cancer (17.8 per 100,000 women) and cause of cancer deaths (9.8 per 100,000) among all types of cancer in women.

Human papillomavirus (HPV) is central to the development of cervical neoplasia and can be detected in 99.7 percent of cervical cancers [3]. The most common histologic types of cervical cancer are squamous cell (69 percent of cervical cancers) and adenocarcinoma (25 percent) [4].

The epidemiology, risk factors, clinical manifestations, and diagnosis of invasive cervical cancer will be reviewed here. Screening and prevention, staging, and the management of cervical cancer and preinvasive disease are discussed separately. (See "Screening for cervical cancer: Rationale and recommendations" and "Invasive cervical cancer: Staging and evaluation of lymph nodes" and "Management of early stage cervical cancer" and "Management of locally advanced cervical cancer" and "Cervical intraepithelial neoplasia: Management of low-grade and high-grade lesions".)

EPIDEMIOLOGY AND RISK FACTORS

Incidence and mortality — Globally, cervical cancer accounted for an estimated 530,000 new cancer cases worldwide and for 275,000 deaths in 2008 [5]. Eighty-six percent of new cervical cancer cases will be seen in developing countries [6]. Worldwide, the mortality rate from cervical cancer is 52 percent [6]. Global incidence and mortality rates depend upon the presence of screening programs for cervical precancer and cancer and of human papillomavirus (HPV) vaccination, which are most likely to be available in developed countries. Due to these interventions, there has been a 75 percent decrease in the incidence and mortality of cervical cancer over the past 50 years in developed countries [7,8].

In developed countries in 2008, cervical cancer was the tenth most common type of cancer in women (9.0 per 100,000 women) and ranked below the top ten causes of cancer mortality (3.2 per 100,000). In contrast, in developing countries it was the second most common type of cancer (17.8 per 100,000) and cause of cancer deaths (9.8 per 100,000) among women. On the continent of Africa and in Central America, cervical cancer is the number one cause of cancer-related mortality among women [6]. (See "Screening for cervical cancer: Rationale and recommendations" and "Screening for cervical cancer in resource-limited settings" and "Recommendations for the use of human papillomavirus vaccines".)

                

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Literature review current through: Oct 2014. | This topic last updated: Nov 10, 2014.
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