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In 2020, cervical cancer is responsible for 604,000 new cases of cancer and over 300,000 deaths worldwide.

It is the fourth most common form of cancer in women, and in regions such as Africa and South America it is the leading cause of cancer death among women.

From an etiological point of view, the human papillomavirus (HPV) is responsible for the pathogenesis of cancer in the majority of cases.

It is a DNA virus that infects the epithelium of the cervix through sexual contact.

However, it can also infect other areas such as:

• the skin of the anogenital area
• the oropharyngeal cavity

in both sexes, causing different types of cancer such as:

• anal cancer
• oropharyngeal cancer

Early cervical cancer is most often asymptomatic, which is why screening is very important.

The most common symptom – if any – is:

• heavy vaginal bleeding
• bleeding after sexual intercourse.

The presymptomatic diagnosis of cervical cancer is done in various ways such as:

• Papanicolaou cytological examination (Pap test)
• Molecular test for the oncogenic HPV virus
• Combination of the two above examinations.

The systematic use of the Pap test since the mid-twentieth century resulted in a sharp drop in mortality from cervical cancer in developed countries within a few decades.

The Pap test is recommended to be performed every 3 years, while the HPV test is recommended every 5 years. If both tests are combined at the same time, the test is also performed every 5 years.

Screening begins after the age of 21, and according to others, at the age of 25.

Vaccination with the HPV vaccine in young girls has been associated with a significant reduction in the risk of HPV infection and, consequently, cervical cancer. The younger the age of vaccination, the better.

The ideal age of vaccination is before the onset of sexual intercourse. The most effective vaccines are the multivalent vaccines against multiple oncogenic substrains of the virus.

It should be noted that the vaccine is not effective against women who have already been infected with HPV, and more importantly, it does not negate the necessity of screening.

The main treatment for early disease is surgery, with the type of operation (cone resection, simple hysterectomy, radical hysterectomy with lymphadenectomy) depending on the local spread of the disease.

Radiation with or without concomitant chemotherapy is used either prophylactically after surgery or in those patients who are not suitable candidates for surgical resection.