Cervical cancer

Cervical cancer incidence is strongly related to the acquisition of oncogenic human papillomaviruses (HPV), which explains that incidence and mortality rates vary largely according to HPV vaccination coverage and screening and treatment capacity across countries. This chapter describes mortality from cervical cancer according to income level countries categories, the natural history of cervical cancer, HPV strains associated with cervical cancer and the available vaccines (which should be administered to adolescent females and males), screening programmes, diagnostic tests (which range from simple cytology to HPV DNA testing) and treatment options. Treatment most often requires surgery, which can range from simple local excision by cryotherapy at the time of detection to a mix of surgery, radiotherapy, systemic chemotherapy and palliative care. As for all cancers, there is a need for networks of care, with centres of excellence that can provide high-quality multidisciplinary care, as well as ensure that treatment is included in universal health care packages at no or minimal cost to the patients.