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Lancet ; 393(10167): 169-182, 2019 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-30638582

RESUMO

Each year, more than half a million women are diagnosed with cervical cancer and the disease results in over 300 000 deaths worldwide. High-risk subtypes of the human papilloma virus (HPV) are the cause of the disease in most cases. The disease is largely preventable. Approximately 90% of cervical cancers occur in low-income and middle-income countries that lack organised screening and HPV vaccination programmes. In high-income countries, cervical cancer incidence and mortality have more than halved over the past 30 years since the introduction of formal screening programmes. Treatment depends on disease extent at diagnosis and locally available resources, and might involve radical hysterectomy or chemoradiation, or a combination of both. Conservative, fertility-preserving surgical procedures have become standard of care for women with low-risk, early-stage disease. Advances in radiotherapy technology, such as intensity-modulated radiotherapy, have resulted in less treatment-related toxicity for women with locally-advanced disease. For women with metastatic or recurrent disease, the overall prognosis remains poor; nevertheless, the incorporation of the anti-VEGF agent bevacizumab has been able to extend overall survival beyond 12 months. Preliminary results of novel immunotherapeutic approaches, similarly to other solid tumours, have shown promising results so far.


Assuntos
Programas de Rastreamento/estatística & dados numéricos , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero , Quimiorradioterapia , Feminino , Saúde Global , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Histerectomia , Incidência , Programas de Rastreamento/métodos , Estadiamento de Neoplasias , Vacinas contra Papillomavirus/imunologia , Pobreza , Fatores de Risco , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/terapia
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