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Overview of approach to cervical cancer survivors

Linda R Duska, MD
Section Editor
Larissa Nekhlyudov, MD, MPH
Deputy Editors
Sadhna R Vora, MD
Sandy J Falk, MD, FACOG


While cervical cancer is the fourth most common cancer of women in the world, the number of cases has continuously declined in regions where screening programs have been implemented. However, in resource-poor areas, where screening programs are not well established, cervical cancer continues to affect and kill hundreds of thousands of women. In 2012, approximately 528,000 new cases were diagnosed worldwide and were responsible for over 260,000 deaths, making it the fourth most common cause of cancer death in women [1]. Seventy percent of the global burden occurs in resource-poor countries, with more than one-fifth of these diagnosed in India [1].

Compared with other gynecologic cancers, cervical cancer most often affects younger women, with a mean age at diagnosis of 49 years [2]. Many of these women with early-stage disease will be cured and have significant additional life expectancy following completion of treatment. Consequently, they will face years of potential treatment-related side effects. They may also have concerns regarding fertility preservation. Finally, given their younger age, these women may have more family and work responsibilities than women with other gynecologic cancers, which will impact their survivorship [3]. Women with locally advanced cervical cancer (LACC) are treated with combination chemotherapy and radiation (chemoRT). While this treatment might be curative, these young women will then live years with significant treatment sequelae, and will also lose their fertility as well as ovarian function as a result of treatment.

This topic will review the approach to cervical cancer survivors.


Following a diagnosis of cervical cancer, all women undergo a pretreatment staging evaluation to help determine the approach, which can then be stratified on whether the disease is early or locally advanced at presentation. The overwhelming majority of long-term cervical cancer survivors were originally treated for early-stage or locally advanced cervical cancer. In contrast, the median survival of women diagnosed with metastatic or recurrent cervical cancer is generally less than two years. Therefore, this section will review the treatment of women with early-stage or locally advanced cervical cancer.

Early-stage cervical cancer — Early-stage cervical cancer is defined as disease confined to the cervix measuring less than 4 cm in size (stage IA to IB1) (table 1). These patients may be appropriately treated with either radical surgery or concomitant chemoradiation, which is usually based on the volume of disease, patient characteristics, and surgical judgment [4]. (See "Management of early-stage cervical cancer".)

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Literature review current through: Nov 2017. | This topic last updated: Mar 03, 2017.
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