Cancer of the cervix uteri: 2021 update

TLDR

Since 2018, WHO has launched a global cervical cancer elimination strategy, HPV vaccination has been incorporated into national programs in over 130 countries, HPV testing has expanded screening, yet the interventions will take years to reduce the annual 500,000 new cases, and FIGO’s 2018 staging has been widely adopted. The chapter aims to review cervical cancer management by stage, emphasizing palliation and quality of life. It does so by discussing stage‑specific treatment strategies and supportive care considerations. Minimally invasive surgery is disadvantageous for cervical cancer patients.

Abstract

Since the publication of the 2018 FIGO Cancer Report, giant strides have been made in the global effort to reduce the burden of cervical cancer, with the World Health Organization (WHO) rolling out a global strategy for cervical cancer elimination, aiming for implementation by 2030. In over 130 countries, including low- and middle-income countries, HPV vaccination is now included in the national program. Screening has seen major advances with wider implementation of HPV testing. These interventions will take a few years to show their impact. Meanwhile, over half a million new cases are added each year. FIGO's revised staging of cervical cancer (2018) has been widely implemented and retrospective analyses of data based on the new staging have been published. Minimally invasive surgery has been shown to be disadvantageous in women with cervical cancer. This chapter discusses the management of cervical cancer based on the stage of disease, including attention to palliation and quality of life issues.