Cervical cancer

Cervical cancer
Location of cervical cancer and an example of normal and abnormal cells
Pronunciation
  • UK: /ˈsɜːrvɪkəl/ SUR-vik-əl, /sɜːrˈvaɪkəl/ sur-VY-kəl
    US: /ˈsɜːrvɪkəl/ SUR-vik-əl[1]
SpecialtyGynecologic oncology
SymptomsEarly: none[2]
Later: vaginal bleeding, pelvic pain, pain during sexual intercourse[2]
Usual onsetMost common in women aged 30–35[3]
TypesSquamous cell carcinoma, adenocarcinoma, others[4]
CausesHuman papillomavirus infection (HPV)[5][6]
Risk factorsSmoking, weak immune system, birth control pills, starting sex at a young age, many sexual partners or a partner with many sexual partners[4][7]
Diagnostic methodCervical screening followed by a biopsy
PreventionRegular cervical screening, HPV vaccine, sexual intercourse with condoms,[8][9] sexual abstinence
TreatmentSurgery, chemotherapy, radiation therapy, immunotherapy[10]
PrognosisFive-year survival rate:
68% (US)
46% (India)[11]
Frequency660,000 new cases (2022)[12]
Deaths350,000 (2022)[12]

Cervical cancer is a type of cancer that develops in the cervix, the lower narrow part of the uterus (womb).[13] It is due to the abnormal growth of cells that can invade or spread to other parts of the body.[14] Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse.[2] While bleeding after sex may not be serious, it may also indicate the presence of cervical cancer.[15]

Almost all cases (99%) are linked to genital human papillomavirus infection (HPV);[16] most who have had HPV infections, however, do not develop cervical cancer.[17][18] The risk is higher in people who smoke, have a weakened immune system, use birth control, start sex at a young age and have many sexual partners.[19] Cervical cancer typically develops from precancerous changes over 10 to 20 years.[17] About 75% of cervical cancers are squamous cell carcinomas, 20–25% are adenocarcinoma.[20] Diagnosis is typically by cervical screening followed by a biopsy. Medical imaging is then done to determine whether or not the cancer has spread beyond the cervix.[21]

HPV vaccination is the most cost-effective public health measure against cervical cancer.[16] HPV vaccines protect against two to seven high-risk strains of this family of viruses and may prevent up to 90% of cervical cancers.[9][22] By the end of 2024, 147 countries provided the HPV vaccine in their national immunization schedule for girls.[23] As of 2022, 47 countries also did it for boys.[24]: 654  As they do not prevent all cervical cancer, guidelines recommend regular screening.[9] Cervical screening allows for the detection of pre-cancer, which can be treated to prevent the development of cancer.[12] Treatment may consist of some combination of surgery, chemotherapy, radiation therapy, and immunotherapy.[10] Five-year survival rates in the United States are 68%,[25] but outcomes depend on how early the cancer is detected.[4]

Worldwide, cervical cancer is both the fourth-most common type of cancer and the fourth-most common cause of death from cancer in women, with over 660,000 new cases and around 350,000 deaths in 2022.[17][12] This is about 8% of the total cases and total deaths from cancer.[26] Almost 90% of cases and deaths occur in low- and middle-income; it makes up 17% of overall cancer cases in women in these countries, compared to 2% in high-income countries.[24]: 650 [27] In developed countries, the widespread use of cervical screening programs has dramatically reduced rates of cervical cancer.[28] In medical research, the most famous immortalized cell line, known as HeLa, was developed from cervical cancer cells of a woman named Henrietta Lacks.[29]

17 November is the Cervical Cancer Elimination Day of Action.[30] The date marks the day in 2020 when WHO launched the Global strategy to accelerate the elimination of cervical cancer as a public health problem, with a resolution passed by 194 countries.[30]

Signs and symptoms

The early stages of cervical cancer may be completely free of symptoms.[5][28] Vaginal bleeding, contact bleeding (one most common forms being bleeding after sexual intercourse), or (rarely) a vaginal mass may indicate the presence of cervical cancer. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer.[31] Bleeding after douching, in between periods or after menopause are also common signs.[2] In advanced disease, metastases may be present in the abdomen, lungs, or elsewhere.[32]

Symptoms of advanced cervical cancer may include loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, swollen legs, heavy vaginal bleeding, bone fractures, and (rarely) leakage of urine or faeces from the vagina.[33] Other signs of locally advanced disease (as the cancer invades organs in the pelvis) include an enlarged kidney with flank pain as urine flow from the kidneys to bladder is blocked, leg swelling and blood clots in the legs as pelvic veins are blocked, rectal bleeding, and bleeding in the urine.[20]

Causes

Infection with some types of HPV is the greatest risk factor for cervical cancer, followed by smoking.[34] HIV infection is also a risk factor.[34]

Human papillomavirus

Infection with HPV is thought to be required for cervical cancer to occur.[35] HPV types 16 and 18 are the cause of 75% of cervical cancer cases globally, while 31 and 45 are the causes of another 10%.[36]

Women who have multiple sexual partners, or have partners who have multiple sexual partners, regardless of sex, are at higher risk of cervical cancer.[37][38]

Over 200 types of HPV known,[39] 12 are classified as high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59),[39] three as probable high-risk (26, 53, and 66), and 12 as low-risk (6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and CP6108).[40] Most cases of squamous cell carcinomas of the cervix are due to HPV type 16 and most cases of adenocarcinoma are due to HPV type 18.[20] High risk HPV viral subtypes can integrate their DNA into the host genome and induce transcription of the viral cancer causing proteins E6 and E7.[20][41] E6 degrades the tumor suppressing protein p53 and E7 degrades and inactivates the tumor suppressing protein pRb. The loss of p53 and pRb leads to increased blood vessel growth feeding tumors (via vascular endothelial growth factor (VEGF) over-expression), loss of tumor cell suppression and cell cycle regulation disruptions, all of which can lead to cervical cancer.[20]

Genital warts, which are a form of benign tumor of epithelial cells, are also caused by various strains of HPV. However, these serotypes are usually not related to cervical cancer. Having multiple strains at the same time is common, including those that can cause cervical cancer along with those that cause warts.

Co-infections and immunosuppression

Having a HPV infection at the same time with other sexually transmitted infections increases risks.[42] This includes HIV and trich (a parasitic infection) and likely chlamydia. A HIV infection makes it more difficult for the body to clear the HPV infection. Women with inflammatory bowel disease who are on immunosuppressive medication also have a higher chance of developing cervical cancer.[43]

Smoking

Cigarette smoking, both active and passive, increases the risk of cervical cancer. Among HPV-infected women, current and former smokers have roughly two to three times the incidence of invasive cancer. Passive smoking is also associated with increased risk, but to a lesser extent.[44] Smoking negatively affects the immune system,[43] making it more difficult for the body to fight off a HPV infection: the virus persists for longer. Smoking can also increase the risk a HPV infection leads to cancer.[45]

Oral contraceptives

Long-term use of oral contraceptives is associated with increased risk of cervical cancer in women who have had HPV. Women who have used oral contraceptives for 5 to 9 years have about three times the incidence of invasive cancer, and those who used them for 10 years or longer have about four times the risk.[44][46]

Multiple pregnancies

Having many pregnancies is associated with an increased risk of cervical cancer. Among HPV-infected women, those who have had seven or more full-term pregnancies have around four times the risk of cancer compared with women with no pregnancies, and two to three times the risk of women who have had one or two full-term pregnancies.[44]

Prevention

Vaccination

Main article: HPV vaccine

Six HPV vaccines are licensed: three bivalent vaccines that protect against two HPV types, two quadrivalent vaccines covering four types, and one nonavalent vaccine that protects against nine types.[47] Three HPV vaccines (Gardasil, Gardasil 9, and Cervarix) reduce the risk of cancerous or precancerous changes of the cervix and perineum by about 93% and 62%, respectively.[48] All have excellent safety profiles and are highly efficacious, or have met immunobridging standards.[24]: 668  The vaccines are between 92% and 100% effective against HPV 16 and 18.[44]

The main target group for HPV vaccination is young adolescent girls, aged 9–14, who get one dose. For older girls and women, and for those living with HIV or otherwise immonocompromised, additional vaccines may be necessary.[47] As of 2022, 125 countries include HPV vaccines in their routine vaccinations for girls, and 47 countries recommend them for boys, as well.[24]: 654 

Many girls in low- and middle-income countries do not have access to the vaccine. Initially, two doses of the vaccine were given for everyone, but the WHO recommendation changed as it has appeared that a single dose is normally as effective as multiple doses. The WHO goal is to get 90% of girls vaccinated by 2030, up from 13% in 2021. This is more achievable on the new single-dose schedule.[49]

Screening

Main articles: Cervical screening and Pap test

Cervical screening for pre-cancerous changes is highly effective in preventing cervical cancer cases and deaths. Different screening methods are in use. The WHO recommends testing for HPV infections as the primary method of screening, but as of 2022, most countries still used a Pap test, which examines cells for (pre)cancerous changes directly. Visual inspection with acetic acid was used in many low-resource regions;[50] the WHO recommends a rapid change to HPV testing for these regions, as accuracy is quite low.[51]

Screening can reveal who is at risk of, or who has abnormal cells on the surface of the cervix called cervical intraepithelial neoplasia (CIN). These precancerous changes can be confirmed with an internal examination known as colposcopy.[51] Low-grade CIN often goes away by itself, but higher-grade CIN frequency changes into cancer later.[52]

The World Health Organization (WHO) recommends screening starts at 30 years of age, except for those living with HIV, where it recommends screening to start at age 25.[51] The 2025 European guidelines recommend screening women between 25 and 64 years using a HPV test. For those between 65 and 69, testing is recommended if there has not been a screening in the last 10 years.[53] In the United States, testing starts at 21.[52]

Recommended intervals depends on the country, type of test, and population risk levels.The WHO recommends a screening interval of 5–10 years for a HPV test, which is increased to 3–5 years for those living with HIV. For countries still using Pap tests, this would be every 3 years.[51] In the United States, screening is recommended to take place every 3 years for a Pap test and every 5 years for a HPV test.[52] HPV vaccination status does not change screening rates.[54]

People who test positively on a HPV test or a Pap smear test, but then negatively during a closer inspection in a colposcopy are recommended to be retested more frequently. The same is true for those who were treated for (pre-)cancer, often after 12 months.[51]

Screening promoting strategies

Personal invitations encouraging women to get screened are effective at increasing the likelihood that they will do so. Educational materials also help increase the likelihood that women will go for screening, but they are not as effective as invitations.[55]

Interventions can help increase rates of cervical cancer screenings, specifically among low and middle-income countries. In efforts to increase life-saving screenings, interventions have proved successful. Single interventions include reminding patients via phone calls, SMS, and subsidized or free services. Combined interventions include multiple steps and can be more effective than single interventions, specifically health education combined with SMS. These interventions make cervical cancer screenings more accessible and less daunting for many at-risk women.[56]

Condoms

Main article: Safe sex

The use of condoms during sexual intercourse decreases but does not eliminate the risk of transmitting the infection.[44] Condoms help protect against infection when used for vaginal, anal and oral sex.[57] They do not necessarily cover all the areas infected with HPV, so they do not offer full protection.[58]

Nutrition

Vitamin A is associated with a lower risk[59] as are vitamin B12, vitamin C, vitamin E, and beta-Carotene.[60]

Diagnosis

Biopsy

Confirmation of the diagnosis of cervical cancer or precancer requires a biopsy of the cervix. This is often done through colposcopy, a magnified visual inspection of the cervix aided by using a dilute acetic acid (e.g. vinegar) solution to highlight abnormal cells on the surface of the cervix,[5] with visual contrast provided by staining the normal tissues a mahogany brown with Lugol's iodine.[61]

Medical devices used for biopsy of the cervix include punch forceps. Colposcopic impression, the estimate of disease severity based on the visual inspection, forms part of the diagnosis. Further diagnostic and treatment procedures are loop electrical excision procedure and cervical conization, in which the inner lining of the cervix is removed to be examined pathologically. These are carried out if the biopsy confirms severe cervical intraepithelial neoplasia.[62][63]

Interventions such as playing music during the procedure and viewing the procedure on a monitor can reduce the anxiety associated with the examination.[64]

Precancerous lesions

Cervical intraepithelial neoplasia (CIN) means the development of abnormal cells on the surface of the cervix. HPV infections cause CIN, but in most cases, it is resolved by the immune system. However, a small percentage of people might develop a more serious CIN, which, if left untreated, can develop into cervical cancer.[65][66] CIN is often diagnosed during routine Pap smear examination or colposcopy.[66]

The naming and histologic classification of cervical carcinoma precursor lesions has changed many times over the 20th century. The World Health Organization classification system was descriptive of the lesions, naming them mild, moderate, or severe dysplasia or carcinoma in situ (CIS).[67][68] The term cervical intraepithelial neoplasia (CIN) was developed to place emphasis on the spectrum of abnormality in these lesions and to help standardize treatment.[68] For premalignant dysplastic changes, cervical intraepithelial neoplasia grading (CIN 1–3) is used. It classifies mild dysplasia as CIN1, moderate dysplasia as CIN2, and severe dysplasia and CIS as CIN3.[69] More recently, CIN2 and CIN3 have been combined into CIN2/3. These results are what a pathologist might report from a biopsy.

These should not be confused with the Bethesda system terms for Pap test (cytopathology) results. Among the Bethesda results: Low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL). An LSIL Pap may correspond to CIN1, and HSIL may correspond to CIN2 and CIN3,[68] but they are results of different tests, and the Pap test results need not match the histologic findings.

Cancer subtypes

Histologic subtypes of invasive cervical carcinoma include:[70][71]

  • Invasive squamous cell carcinoma of the cervix is characterized by infiltration as irregular anastomosing nests or single cells.[74] This case is poorly differentiated. H&E stain.
  • Cervical squamous cell carcinoma generally shows diffuse staining of both nuclei and cytoplasm on p16 immuno-
    histochemistry     (except verrucous variant).[75]
  • Invasive cervical squamous cell carcinoma on H&E histopathology and Ki-67 immunohistochemistry. The latter correlates well with the degree and level of dysplasia.[76]
  • The location of cervical cancer can be described in terms of quadrants, or corresponding to a clock face when the subject is in supine position.

Though squamous cell carcinoma is the cervical cancer with the highest incidence, the incidence of adenocarcinoma of the cervix has been increasing in recent decades.[5] Endocervical adenocarcinoma represents 20–25% of the histological types of cervical carcinoma. Gastric-type mucinous adenocarcinoma of the cervix is a rare type of cancer with aggressive behavior. This type of malignancy is not related to high-risk human papillomavirus (HPV).[77] Noncarcinoma malignancies, which can rarely occur in the cervix, include melanoma and lymphoma.

Staging

Main article: Cervical cancer staging

Cervical cancer is staged by the 2018 FIGO system, which is based on clinical findings (symptoms and signs found during a physical exam), imaging and pathological examination of tissue samples viewed under a microscope.[78] The cancer is staged so that the best treatment can be selected and a prognosis can be given. There are 9 stages, ranging from microscopic cancer in stage 1A to metastatic cancer spread to distant organs in stage 4B. The stages are further subdivided into sub-stages, e.g. 1B3.[79]

Before the 2018 revisions to FIGO staging, the system allowed only these diagnostic tests to be used in determining the stage: palpation, inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, and X-ray examination of the lungs and skeleton, and cervical conization.[80]

  • Stage 1A cervical cancer
  • Stage 1B cervical cancer
  • Stage 2A cervical cancer
  • Stage 2B cervical cancer
  • Stage 3B cervical cancer
  • Stage 4A cervical cancer
  • Stage 4B cervical cancer

Treatment

The treatment of cervical cancer varies worldwide, largely due to access to surgeons skilled in radical pelvic surgery and the emergence of fertility-sparing therapy in developed nations.

Less advanced stages of cervical cancer typically have treatment options that allow fertility to be maintained if the patient desires.[81]

Because cervical cancers are radiosensitive, radiation may be used in all stages where surgical options do not exist. Surgical intervention may have better outcomes than radiological approaches.[82] In addition, chemotherapy can be used to treat cervical cancer and is more effective than radiation alone.[83] Chemoradiotherapy may increase overall survival and reduce the risk of disease recurrence compared to radiotherapy alone.[84]

For surgery to be curative, the entire cancer must be removed with no cancer found at the margins of the removed tissue on examination under a microscope.[85] For recurrent cancer, a surgical procedure may remove the uterus, cervix, vagina and bladder.[20]

Precancerous lesions

Precancerous cells (cervical intraepithelial neoplasia) that would lead to cancer can be treated effectively by surgery. Surgical methods include excision, where a cone-shaped portion of the cervix is removed (e.g. a loop electrical excision procedure), and ablation, which removes only the parts with abnormal tissues with heat (e.g. a laser) or cold (cryotherapy).[62][63]

While these effectively reduce the risk of cancer developing or spreading, they increase the risk of premature birth in future pregnancies. Procedures that remove more cervical tissue lower the chance of the cancer coming back, but they also raise the risk of preterm birth. Due to this risk, taking into account the age, childbearing plans of the woman, and the size and location of the cancer cells are crucial for choosing the right procedure.[62][63]

Early stage

Treatment for early stage cervical cancer depends on whether fertility is a priority. In stages IA to IIA there are typically fertility-preserving options.[81]

Stage IA1 cancer can be treated with a cone biopsy, just like pre-cancerous lesions. If the cone biopsy shows cancer cells at the edge of the removed tissue (that is, the margins are not clear), further surgery is needed. This can be a repeat cone biopsy or a trachelectomy, which removes the cervix. If fertility is not a priority, a simple or radical hysterectomy (removal of the whole uterus, including part of the vagina) is an option.[81] Open surgery has better survival outcomes than keyhole surgery for radical hysterectomy.[86]

For stage IA2, the lymph nodes are removed as well with a cone biopsy or trachelectomy. Alternatives that do not preserve fertility include external beam radiotherapy to the pelvis with brachytherapy (internal radiation), or a radical hysterectomy.[81] In radiotherapy, or radiation therapy, high-energy x-rays or alternative forms of radiation are used to kill cancer cells.[87]

In stage IB1 and IB2, the only fertility-sparing option is a radical trachelectomy with removal of lymph nodes.[81] A radical abdominal trachelectomy with lymphadenectomy usually only requires a two- to three-day hospital stay, and most women recover very quickly (about six weeks). Complications are uncommon, although women who can conceive after surgery are susceptible to preterm labour and possible late miscarriage.[88] A wait of at least one year is generally recommended before attempting to become pregnant after surgery.[89] Recurrence in the residual cervix is rare if the trachelectomy has cleared the cancer.[90]

Early stages (IB1 and IIA less than 4 cm) can be treated with radical hysterectomy with removal of the lymph nodes or radiation therapy. Radiation therapy is given as external beam radiotherapy to the pelvis and brachytherapy (internal radiation).[91] Women treated with surgery who have high-risk features found on pathologic examination are given radiation therapy with or without chemotherapy to reduce the risk of relapse. A Cochrane review has found moderate-certainty evidence that radiation decreases the risk of disease progression in people with stage IB cervical cancer when compared to no further treatment.[92] However, little evidence was found on its effects on overall survival.[92]

For pregnant women with early-stage cervical cancer, one option is to monitor the cancer. In the third tremester, a drug can be given to help speed up the development of lungs of the fetus. A C-section in week 34 of pregnancy avoids vaginal delivery, which can be dangerous with the cancer. The C-section surgery is combined with a hysterectomy. Chemotherapy can be administered from the second tremester, but would interfere with development of the fetus in the first.[20]

Locally advanced

Locally advanced tumors (stages IB3–IVA) are typically treated with concurrent radiation and chemotherapy.[93] In earlier stage locally advanced cancer, a hysterectomy is sometimes an option, which would be followed by chemoradiation if the surgery finds cancer in the lymph nodes or at the margins of the removed tissue.[81] A Cochrane review found a lack of evidence on the benefits and harms of primary hysterectomy compared to primary chemoradiotherapy for cervical cancer in stage IB2 (now IB3).[94]

Cisplatin and carboplatin are typical chemotherapy drugs used in cervical cancer.[81] Cisplatin is preferably used, but carboplatin has fewer side effects, and is used in those intolerant to cisplatin.[95] These two platinum-based chemotherapy drugs, in addition to radiation seems not only to improve survival but also to reduce risk of recurrence in women with early-stage cervical cancer (IA2–IIA).[96]

A short intense course of chemotherapy before radiochemotherapy starts (induction chemotherapy) likely increased survival. Similarly, in those with high-risk locally advanced cancer, the immunotherapy drug pembrolizumab seems to increase survival.[93]

  • Diagram showing the area removed with a posterior surgery
  • Diagram showing the area removed with a total operation
  • Diagram showing the area removed with an anterior operation

Recurrent or metastatic

Recurrent or metastatic cervical cancer is usually not considered curable.[81] Standard treatment starts from a combination of chemotherapy drugs cisplatin or carboplatin, with another chemotherapy drug paclitaxel. Various drugs are added to this combination. One option is to add bevacizumab, a drug that hinders new blood vessel formation. The HPV virus stimulates the creation of new blood vessels, which this drug counteracts.[95]

A further addition is immunotherapy, which stimulates the body's immune system to treat cancer.[10] If the tumor is PD-L1 positive (which is true for most recurrent or metastatic tumors), pembrolizumab can be added to the treatment.[81][95] Pembrolizumab is an immune checkpoint inhibitor, which removed the 'breaks' from the immune system that normally prevent it from attacking healthy cells. Cancer sometimes evades the immune system via these immune checkpoints. Two other immune checkpoint inhibitors are used for cervical cancer: cemiplimab (Libtayo), for people with recurrent cancer after prior systemic treatment, and Nivolumab (Opdivo), which is used after all other options have been tried.[97]

As a second-line treatment, tisotumab vedotin (Tivdak), an antibody-drug conjugate, can be used.[95] The antibody binds to a protein on the cancer cells, so it can enter the cell. Once inside, the linked chemotherapy drug can directly destroy the cancer cell.[98] As such, it is a targeted therapy.[95] It was approved in the United States in 2021, and in the EU in 2025.[98][99]

Psychosocial intervention

Psychosocial interventions among cervical cancer patients decrease depression and anxiety levels, all while having a positive impact on quality of life, cortisol levels, self-efficacy, fatigue, sleep status, and sexual dysfunction.[100] Mindfulness-based interventions have been proven helpful in additionally decreasing depression and anxiety levels of patients with cervical cancer.[100]

Prognosis

Stage

The prognosis depends on the stage of the cancer. The prognosis for squamous cell carcinoma and adenocarcinoma of the cervix is roughly the same for each given stage.[20] For pre-cancerous lesions, the prognosis is good.[101] In the United States, the five-year survival rate for FIGO stage 1 (cancer confined to the cervix) cervical cancer is 91%, and the overall (all stages combined) five-year survival rate is about 68%.[20][25] Five-year survival in Stage 2 disease (cancer invading beyond upper two-thirds of uterus) is 65%.[20] Stage 3 disease (in which the lower one-third of vagina, pelvic wall is involved or presence of hydronephrosis, pelvic or peri-aortic lymph node involvement) is 35%. Stage 4 disease, in which cancer extends beyond the pelvis, or involves the bladder or rectum, has a 5-year survival rate of 7%.[20]

Alomst a third of women with locally advanced cancer will have recurrent disease after treatment.[102]

By country

There is an ethnic disparity in five-year survival in the United States. Average survival rates of the dominant squamous cell carcinoma are 72% for Hispanic and Asian-Pacific women, 68% for White women and 61% for Black women.[103]

Regular screening has meant that precancerous changes and early-stage cervical cancers have been detected and treated early. Figures suggest that cervical screening is saving 5,000 lives each year in the UK by preventing cervical cancer.[104] About 1,000 women per year die of cervical cancer in the UK. All of the Nordic countries have cervical cancer screening programs in place.[105] The Pap test was integrated into clinical practice in the Nordic countries in the 1960s.[105]

In Africa, outcomes are often worse as diagnosis is frequently at a later stage of the disease.[106] In a scoping review of publicly-available cervical cancer prevention and control plans from African countries, plans tended to emphasize survivorship rather than early HPV diagnosis and prevention.[107]

Adverse effects

Chemotherapy works by attacking cells that rapidly divide. This kills cancer cells, but can also impact normal cells, leading to adverse side effects. Common chemotherapy side effects include: hair loss, mouth sores, loss of appetite, diarrhea, nausea and vomiting, premature menopause, infertility, and damage to the blood-forming cells within bone marrow. Most acute side effects are temporary, dissipating when treatment ceases, but some can be long-lasting or permanent. Long-term chemotherapy side effects include changes in the menstrual cycle, neuropathy, and nephrotoxicity.[108]

Radiation therapy (RT) adverse effects; for a complete side effect list see

Main article: Radiation therapy § Side effects

Curative cervical radiation therapy may affect unintended tissues located within the delivery pathway(s) or adjacent to the target lesion, each tissue with a unique sensitivity and response to radiation injury. Common acute RT effects involve the gastrointestinal system, e.g., diarrhea and constipation; urinary tract, e.g., frequent urination; and may cause cervicitis. Common late RT complications include: infertility or premature ovarian failure; vaginal stenosis; lower motor neuron syndrome; telangiectasias, and subsequent hemorrhage; and progressive myelopathy, which may result in irreversible neurologic deficits ranging from minor sensory symptoms to complete paraplegia.[109] Radiotherapy late effects (with occurrence rates) include osteonecrosis (8–20%), bladder ulceration (<3%), vaginal stenosis (>2.5%)[110] and chronic pelvic radiation disease (1–10%), e.g., irreversible lumbosacral plexopathy.[111]

Pelvic radiation also induces secondary malignancies such as leukemia, lymphoma, bladder cancer, pelvic malignancy, colorectal cancer, bone, and soft-tissue sarcoma with occurrence rates between 0.2 and 1.0% per year for each.[109]

Epidemiology

Worldwide, cervical cancer is both the fourth-most common type of cancer and the fourth-most common cause of death from cancer in women, with over 660,000 new cases and around 350,000 deaths in 2022.[17][12] It is the second-most common cause of female-specific cancer after breast cancer, accounting for around 8% of both total cancer cases and total cancer deaths in women.[26] In 2020, 88% of cervical cancers and 90% of deaths occurred in low- and middle-income countries (LMICs).[24]: 650 [27] It is the most frequently detected cancer during pregnancy, with an occurrence of 1.5 to 12 for every 100,000 pregnancies.[113]

[Cervical cancers] account for 17% of all cancers in women, compared with only 2% in high-income countries (HICs). In sub-Saharan Africa, the region with the highest rates of young women living with HIV (WLWH), approximately 20% of cervical cancer cases occur in WLWH. HPV infection is more likely to persist and to progress to cancer in WLWH. Mortality rates vary 50-fold between countries, ranging from <2 per 100,000 women in some HICs to >40 per 100,000 in some countries of sub-Saharan Africa.[24]: 650 

Africa

Of the 20 hardest hit countries by cervical cancer, 19 are in Africa.[114]

The Nigerian Institute of Medical Research (NIMR) reports that 28 Nigerian women lose their lives daily due to this disease. Many Nigerian women lack access to these preventive measures. In many regions of the country, screening tests such as Pap tests and HPV tests are not easily accessible or affordable.[115][116]

Australia

Australia is on target to eliminate cervical cancer, defined as having fewer than four new cases per 100,000 women annually. It anticipates achieving this by 2033.[117]

In 2022, it is estimated that 942 new cases of cervical cancer will be diagnosed in Australia. In 2022, it is estimated that a female has a 1 in 180 (or 0.56%) risk of being diagnosed with cervical cancer by the age of 85.[118]

In 2020, there were 165 women aged 25–74 who died from cervical cancer, which is a mortality rate of 2 deaths per 100,000 women in the population. Over the 5 years 2016–2020, the age-standardised mortality rate among Aboriginal and Torres Strait Islander women was 3.8 times the rate of non-Indigenous Australians.[119]

The number of women diagnosed with cervical cancer has dropped on average by 4.5% each year since organised screening began in 1991 (1991–2005).[120]

Asia

In India, the number of people with cervical cancer is rising, but overall, the age-adjusted rates are decreasing.[121][122] Usage of condoms in the female population has improved the survival of women with cancers of the cervix.[123]

Hundreds of women in Nepal are diagnosed with cervical cancer each year, primarily caused by human papillomavirus (HPV) infection. In February 2025, Nepal launched a nationwide HPV vaccination campaign targeting over 1.6 million girls aged 10–15, supported by WHO, UNICEF, and GAVI, alongside educational programs to raise awareness and prevent cervical cancer [124]

North America

An estimated 1,450 Canadians will be diagnosed with cervical cancer in 2022. An estimated 380 will die from it.[125]

An estimated 13,360 new cervical cancers and 4,320 cervical cancer deaths will occur in the United States in 2025. The median age at diagnosis is 50. The rate of new cases in the United States was 7.7 per 100,000 women, based on rates from 2018 to 2022.[25] Cervical cancer deaths decreased by approximately 74% in the 50 years leading up to 2010, largely due to widespread Pap test screening.[126] The annual direct medical cost of cervical cancer prevention and treatment before the introduction of the HPV vaccine was estimated at $6 billion.[126]

Europe

As of 2022, the World Health Organization announced that "each year in the WHO European Region, more than 66,000 women are newly diagnosed with cervical cancer and more than 30,000 die from this preventable disease."[127] In the UK, cervical cancer is the 14th-most common cancer in women in the UK (around 3,300 women were diagnosed yearly in 2017–2019) and accounts for 1% of cancer deaths (around 890 died yearly in 2021–2023).[128]

History

  • 400 BCE: Hippocrates noted that cervical cancer was incurable.
  • 1925: Hinselmann invented the colposcope.
  • 1928: Papanicolaou developed the Papanicolaou technique.
  • 1941: Papanicolaou and Traut: Pap test screening began.
  • 1946: Aylesbury spatula was developed to scrape the cervix, collecting the sample for the Pap test.
  • 1951: First successful in-vitro cell line, HeLa, derived from biopsy of cervical cancer of Henrietta Lacks.
  • 1976: Harald zur Hausen and Gisam found HPV DNA in cervical cancer and genital warts; Hausen later won the Nobel Prize for his work.[129]
  • 1988: Bethesda System for reporting Pap results was developed.
  • 2006: First HPV vaccine was approved by the FDA.
  • 2015: HPV vaccine shown to protect against infection at multiple body sites.[130]
  • 2018: Evidence for single-dose protection with HPV vaccine.[131]

Epidemiologists working in the early 20th century noted that cervical cancer behaved like a sexually transmitted disease. In summary:

  1. Cervical cancer was noted to be common in female sex workers.
  2. It was rare in nuns, except for those who had been sexually active before entering the convent (Rigoni in 1841).
  3. It was more common in the second wives of men whose first wives had died from cervical cancer.
  4. It was rare in Jewish women.[132]
  5. In 1935, Syverton and Berry discovered a relationship between CRPV (Cottontail Rabbit Papillomavirus) and skin cancer in rabbits.[133] (HPV is species-specific and therefore cannot be transmitted to rabbits).[134]

These historical observations suggested a sexually transmitted agent caused cervical cancer. Initial research in the 1940s and 1950s attributed cervical cancer to smegma.[135] During the 1960s and 1970s it was suspected that infection with herpes simplex virus (HSV) was the cause of the disease. In summary, HSV was seen as a likely cause because it is known to survive in the female reproductive tract, and to be transmitted sexually in a way compatible with known risk factors, such as promiscuity and low socioeconomic status.[136] Herpes viruses were also implicated in other malignant diseases, including Burkitt's lymphoma, Nasopharyngeal carcinoma, Marek's disease and the Lucké renal adenocarcinoma. HSV was recovered from cervical tumour cells.

A description of human papillomavirus (HPV) by electron microscopy was given in 1949, and HPV-DNA was identified in 1963.[137] It was not until the 1980s that HPV was identified in cervical cancer tissue.[138] It has since been demonstrated that HPV is implicated in virtually all cervical cancers.[139] Specific viral subtypes implicated are HPV 16, 18, 31, 45 and others.

In work that was initiated in the mid-1980s, the HPV vaccine was developed, in parallel, by researchers at Georgetown University Medical Center, the University of Rochester, the University of Queensland in Australia, and the U.S. National Cancer Institute.[140] In 2006, the US Food and Drug Administration (FDA) approved the first preventive HPV vaccine, marketed by Merck & Co. under the trade name Gardasil.

17 November is the Cervical Cancer Elimination Day of Action.[30] The date marks the day in 2020 when WHO launched the Global strategy to accelerate the elimination of cervical cancer as a public health problem, with a resolution passed by 194 countries.[30] In November 2020, the World Health Organization (WHO), under backing from the World Health Assembly, set out a strategy to eliminate cervical cancer by 2050. The strategy involves vaccinating 90% of girls by the age of 15, screening 70% of women by the age of 35 and again by the age of 45, and treating 90% of women identified with cervical disease.[141] To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 100 000 women.[117][142]

Society and culture

Australia

In Australia, Aboriginal women are more than five times more likely to die from cervical cancer than non-Aboriginal women, suggesting that Aboriginal women are less likely to have regular Pap tests.[143] Several factors may limit indigenous women from engaging in regular cervical screening practices, including sensitivity in discussing the topic in Aboriginal communities, embarrassment, anxiety and fear about the procedure.[144] Difficulty in accessing screening services (for example, transport difficulties) and a lack of female GPs, trained Pap test providers and trained female Aboriginal Health Workers are also issues.[144]

The Australian Cervical Cancer Foundation (ACCF), founded in 2008, promotes 'women's health by eliminating cervical cancer and enabling treatment for women with cervical cancer and related health issues, in Australia and in developing countries.'[145] Ian Frazer, one of the developers of the Gardasil cervical cancer vaccine, is the scientific advisor to ACCF.[146] Janette Howard, the wife of the then-Prime Minister of Australia, John Howard, was diagnosed with cervical cancer in 1996, and first spoke publicly about the disease in 2006.[147]

United States

A 2007 survey of American women found 40% had heard of HPV infection, and less than half of those knew it causes cervical cancer.[148] Over a longitudinal study from 1975 to 2000, it was found that people of lower socioeconomic census brackets had higher rates of late-stage cancer diagnosis and higher morbidity rates. After controlling for stage, there still existed differences in survival rates.[149] Women in the US experience stigma around HPV infection, vaccination, and cervical cancer. This is predominantly driven by fear of social judgment and rejection, self-blame, and shame, with notable negative influences from gender and social norms, as both human papillomavirus infection and cervical cancer were stigmatized due to the perception that they arise from reckless behavior such as having multiple sexual partners or neglecting screening.[150]

LGBTQ populations

Transgender men and gender-diverse people who have a cervix (even if partially intact) or have a prior history of cervical cancer or precancerous conditions, and are age 21 or older, who have ever had sex with anyone, need to get screened for cervical cancer.[151][152] Transmasculine people are just as likely as cisgender women to have cervical cancer, but are less likely to undergo cervical screening, because of dysphoria, gender disaffirmation or disempowerment of the individual by healthcare providers,[153] or being misinformed of HPV and cervical cancer risks[154] as well as many healthcare providers perceiving transmasculine individuals to be at low risk of cervical cancer.[155]

Transgender women who have not had bottom surgery have no risk of cervical cancer, as they do not have a cervix. Trans women who have had bottom surgery to create a vagina (vaginoplasty) and possibly a cervix, are at low risk to develop cancer in the tissues of their neo-vagina or neo-cervix as these tissues are made up of different cells than a cervix in a cisgender woman.[156][157] Cervical cancer screening is not necessary in trans women who have undergone vaginoplasty because they do not have a cervix.[158]

Intersex people with a cervix are also able to have cervical cancer.[159]

References

  1. ^ "CERVICAL | meaning in the Cambridge English Dictionary". dictionary.cambridge.org. Archived from the original on 16 May 2018. Retrieved 5 October 2019.
  2. ^ a b c d "Signs and Symptoms of Cervical Cancer". American Cancer Society. 1 July 2025. Archived from the original on 8 February 2026. Retrieved 14 February 2026.
  3. ^ "What is cervical cancer?". nhs.uk. 18 September 2024. Retrieved 8 March 2026.
  4. ^ a b c "Cervical Cancer Treatment (PDQ®)". National Cancer Institute. 14 March 2014. Archived from the original on 5 July 2014. Retrieved 25 June 2014.
  5. ^ a b c d Kumar V, Abbas AK, Fausto N, Mitchell RN (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 718–721. ISBN 978-1-4160-2973-1.
  6. ^ Kufe D (2009). Holland-Frei cancer medicine (8th ed.). New York: McGraw-Hill Medical. p. 1299. ISBN 978-1-60795-014-1. Archived from the original on 1 December 2015.
  7. ^ Bosch FX, de Sanjosé S (2007). "The epidemiology of human papillomavirus infection and cervical cancer". Disease Markers. 23 (4): 213–227. doi:10.1155/2007/914823. PMC 3850867. PMID 17627057.
  8. ^ "Cervical Cancer Prevention (PDQ®)". National Cancer Institute. 27 February 2014. Archived from the original on 6 July 2014. Retrieved 25 June 2014.
  9. ^ a b c "Human Papillomavirus (HPV) Vaccines". National Cancer Institute. 25 May 2021. Archived from the original on 23 November 2025. Retrieved 14 February 2026.
  10. ^ a b c "Cervical Cancer Treatment". National Cancer Institute. 3 April 2025. Archived from the original on 22 November 2025. Retrieved 13 February 2026.
  11. ^ "Global Cancer Facts & Figures 3rd Edition" (PDF). 2015. p. 9. Archived (PDF) from the original on 22 August 2017. Retrieved 29 August 2017.
  12. ^ a b c d e "Cervical cancer". World Health Organization. 2 December 2025. Archived from the original on 22 April 2023. Retrieved 14 February 2026.
  13. ^ "What Is Cervical Cancer?". National Cancer Institute. 13 October 2022. Archived from the original on 16 November 2023. Retrieved 13 February 2026.
  14. ^ "Defining Cancer". National Cancer Institute. 17 September 2007. Archived from the original on 25 June 2014. Retrieved 10 June 2014.
  15. ^ Tarney CM, Han J (2014). "Postcoital bleeding: a review on etiology, diagnosis, and management". Obstetrics and Gynecology International. 2014 192087. doi:10.1155/2014/192087. PMC 4086375. PMID 25045355.
  16. ^ a b "Immunizing against HPV". World Health Organization. Archived from the original on 4 November 2024. Retrieved 6 October 2024.
  17. ^ a b c d World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.12. ISBN 978-92-832-0429-9.
  18. ^ Dunne EF, Park IU (December 2013). "HPV and HPV-associated diseases". Infectious Disease Clinics of North America. 27 (4): 765–778. doi:10.1016/j.idc.2013.09.001. PMID 24275269.
  19. ^ Ramachandran D, Dörk T (October 2021). "Genomic Risk Factors for Cervical Cancer". Cancers. 13 (20): 5137. doi:10.3390/cancers13205137. PMC 8533931. PMID 34680286.
  20. ^ a b c d e f g h i j k Tewari KS (2 January 2025). "Cervical Cancer". New England Journal of Medicine. 392 (1): 56–71. doi:10.1056/NEJMra2404457. PMID 39752299.
  21. ^ "Cervical Cancer Diagnosis". National Cancer Institute. 13 October 2022. Retrieved 17 February 2026.
  22. ^ Tran NP, Hung CF, Roden R, Wu TC (2014). "Control of HPV Infection and Related Cancer Through Vaccination". Viruses and Human Cancer. Recent Results in Cancer Research. Vol. 193. pp. 149–171. doi:10.1007/978-3-642-38965-8_9. ISBN 978-3-642-38964-1. PMID 24008298.
  23. ^ "Immunization coverage". World Health Organization. 15 July 2025. Archived from the original on 10 August 2022. Retrieved 13 February 2026.
  24. ^ a b c d e f "Human papillomavirus vaccines: WHO position paper (2022 update)". Weekly Epidemiological Record. 97 (50): 645–672. December 2022. hdl:10665/365351.
  25. ^ a b c "SEER Stat Fact Sheets: Cervix Uteri Cancer". NCI. National Cancer Institute. Archived from the original on 8 February 2026. Retrieved 7 January 2026.
  26. ^ a b World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 1.1. ISBN 978-92-832-0429-9.
  27. ^ a b "WHO adds an HPV vaccine for single-dose use". World Health Organization. 4 October 2024. Archived from the original on 6 October 2024. Retrieved 6 October 2024.
  28. ^ a b Canavan TP, Doshi NR (March 2000). "Cervical cancer". American Family Physician. 61 (5): 1369–1376. PMID 10735343. Archived from the original on 6 February 2005.
  29. ^ Carraher Jr CE (2014). Carraher's polymer chemistry (9th ed.). Boca Raton: Taylor & Francis. p. 385. ISBN 978-1-4665-5203-6. Archived from the original on 22 October 2015.
  30. ^ a b c d "Cervical Cancer Elimination Day of Action". World Health Organization. Archived from the original on 7 October 2024. Retrieved 6 October 2024.
  31. ^ "Cervical Cancer Symptoms, Signs, Causes, Stages & Treatment". medicinenet.com. Archived from the original on 27 July 2020. Retrieved 28 May 2018.
  32. ^ Li H, Wu X, Cheng X (July 2016). "Advances in diagnosis and treatment of metastatic cervical cancer". Journal of Gynecologic Oncology. 27 (4) e43. doi:10.3802/jgo.2016.27.e43. PMC 4864519. PMID 27171673.
  33. ^ "Cervical cancer". MedlinePlus Medical Encyclopedia. National Institutes of Health. 9 June 2006. Archived from the original on 11 October 2007. Retrieved 2 December 2007.
  34. ^ a b Gadducci A, Barsotti C, Cosio S, Domenici L, Riccardo Genazzani A (August 2011). "Smoking habit, immune suppression, oral contraceptive use, and hormone replacement therapy use and cervical carcinogenesis: a review of the literature". Gynecological Endocrinology. 27 (8): 597–604. doi:10.3109/09513590.2011.558953. PMID 21438669. S2CID 25447563.
  35. ^ Snijders PJ, Steenbergen RD, Heideman DA, Meijer CJ (January 2006). "HPV-mediated cervical carcinogenesis: concepts and clinical implications". The Journal of Pathology. 208 (2): 152–164. doi:10.1002/path.1866. PMID 16362994. S2CID 25400770.
  36. ^ Dillman RK, Oldham RO, eds. (2009). Principles of cancer biotherapy (5th ed.). Dordrecht: Springer. p. 149. ISBN 978-90-481-2289-9. Archived from the original on 29 October 2015.
  37. ^ "What Causes Cancer of the Cervix?". American Cancer Society. 30 November 2006. Archived from the original on 13 October 2007. Retrieved 2 December 2007.
  38. ^ Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K (June 2001). "Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women". American Journal of Public Health. 91 (6): 947–952. doi:10.2105/AJPH.91.6.947. PMC 1446473. PMID 11392939.
  39. ^ a b "HPV and Cancer – NCI". www.cancer.gov. 1 March 2019. Archived from the original on 4 June 2024. Retrieved 13 February 2024.
  40. ^ Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsagué X, Shah KV, et al. (February 2003). "Epidemiologic classification of human papillomavirus types associated with cervical cancer". The New England Journal of Medicine. 348 (6): 518–527. doi:10.1056/NEJMoa021641. hdl:2445/122831. PMID 12571259. S2CID 1451343. Archived from the original on 15 April 2023. Retrieved 29 March 2023.
  41. ^ Peng Q, Wang L, Zuo L, Gao S, Jiang X, Han Y, et al. (January 2024). "HPV E6/E7: insights into their regulatory role and mechanism in signaling pathways in HPV-associated tumor". Cancer Gene Therapy. 31 (1): 9–17. doi:10.1038/s41417-023-00682-3. PMID 38102462.
  42. ^ "Cervical cancer and HPV: What are the risk factors?". NICE Clinical Knowledge Summaries. April 2025. Retrieved 17 February 2026.
  43. ^ a b Bowden SJ, Doulgeraki T, Bouras E, Markozannes G, Athanasiou A, Grout-Smith H, et al. (27 July 2023). "Risk factors for human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer: an umbrella review and follow-up Mendelian randomisation studies". BMC Medicine. 21 (1): 274. doi:10.1186/s12916-023-02965-w. ISSN 1741-7015. PMC 10375747. PMID 37501128.
  44. ^ a b c d e "Cervical Cancer Prevention". PDQ. Bethesda, MD: National Cancer Institute, National Institutes of Health. 26 December 2022. Archived from the original on 8 April 2015. Retrieved 20 May 2015.
  45. ^ Farina S, Sabatelli A, Boccia S, Scambia G (25 April 2025). "Environment, lifestyle, and cancer in women". International Journal of Gynecology & Obstetrics. 171 (S1): 138–146. doi:10.1002/ijgo.70156. ISSN 0020-7292. PMC 12411823. PMID 40277318. Archived from the original on 19 July 2025.
  46. ^ Asthana S, Busa V, Labani S (April 2020). "Oral contraceptives use and risk of cervical cancer – A systematic review & meta-analysis". European Journal of Obstetrics, Gynecology, and Reproductive Biology. 247: 163–175. doi:10.1016/j.ejogrb.2020.02.014. PMID 32114321. S2CID 211728228.
  47. ^ a b "Human papillomavirus vaccines (HPV)". World Health Organization. Archived from the original on 7 August 2024. Retrieved 18 February 2026.
  48. ^ Medeiros LR, Rosa DD, da Rosa MI, Bozzetti MC, Zanini RR (October 2009). "Efficacy of human papillomavirus vaccines: a systematic quantitative review". International Journal of Gynecological Cancer. 19 (7): 1166–1176. doi:10.1111/IGC.0b013e3181a3d100. PMID 19823051. S2CID 24695684.
  49. ^ Kreimer AR, Cernuschi T, Rees H, Brotherton JM, Porras C, Schiller J (9 March 2023). "Public health opportunities resulting from sufficient HPV vaccine supply and a single-dose vaccination schedule". JNCI: Journal of the National Cancer Institute. 115 (3): 246–249. doi:10.1093/jnci/djac189. ISSN 0027-8874. PMC 9996208. PMID 36194015.
  50. ^ Bruni L, Serrano B, Roura E, Alemany L, Cowan M, Herrero R, et al. (2022). "Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis". The Lancet Global Health. 10 (8): e1115–e1127. doi:10.1016/S2214-109X(22)00241-8. ISSN 2214-109X. PMC 9296658. PMID 35839811.
  51. ^ a b c d e World Health Organization (2021). WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention (2nd ed.). Geneva: World Health Organization. pp. xi–xv, 1. ISBN 978-92-4-003082-4.
  52. ^ a b c CDC (26 February 2025). "Screening for Cervical Cancer". Cervical Cancer. Retrieved 15 February 2026.
  53. ^ "IARC collaborates with the JRC to release the first set of recommendations for cervical cancer screening in the European Union". World Health Organization. Retrieved 15 February 2026.
  54. ^ Committee on Practice Bulletins—Gynecology (November 2012). "ACOG Practice Bulletin Number 131: Screening for cervical cancer". Obstetrics and Gynecology. 120 (5): 1222–1238. doi:10.1097/AOG.0b013e318277c92a. PMID 23090560.
  55. ^ Staley H, Shiraz A, Shreeve N, Bryant A, Martin-Hirsch PP, Gajjar K (September 2021). "Interventions targeted at women to encourage the uptake of cervical screening". The Cochrane Database of Systematic Reviews. 2021 (9) CD002834. doi:10.1002/14651858.CD002834.pub3. PMC 8543674. PMID 34694000.
  56. ^ Tin KN, Ngamjarus C, Rattanakanokchai S, Sothornwit J, Aue-aungkul A, Paing AK, et al. (23 March 2023). "Interventions to increase the uptake of cervical cancer screening in low- and middle-income countries: a systematic review and meta-analysis". BMC Women's Health. 23 (1): 120. doi:10.1186/s12905-023-02265-8. ISSN 1472-6874. PMC 10035175. PMID 36959632.
  57. ^ Hristamyan MA (30 September 2025). "Primary and Secondary Prophylaxis for Diseases Caused by Human Papillomavirus Infections". Journal of Cancer Prevention. 30 (3): 146–153. doi:10.15430/JCP.25.018. ISSN 2288-3649. PMC 12527971. PMID 41112418.
  58. ^ Wolf J, Kist LF, Pereira SB, Quessada MA, Petek H, Pille A, et al. (2024). "Human papillomavirus infection: Epidemiology, biology, host interactions, cancer development, prevention, and therapeutics". Reviews in Medical Virology. 34 (3). doi:10.1002/rmv.2537. ISSN 1052-9276. Archived from the original on 27 May 2025. Retrieved 14 February 2026.
  59. ^ Zhang X, Dai B, Zhang B, Wang Z (February 2012). "Vitamin A and risk of cervical cancer: a meta-analysis". Gynecologic Oncology. 124 (2): 366–373. doi:10.1016/j.ygyno.2011.10.012. PMID 22005522.
  60. ^ Myung SK, Ju W, Kim SC, Kim H (October 2011). "Vitamin or antioxidant intake (or serum level) and risk of cervical neoplasm: a meta-analysis". BJOG. 118 (11): 1285–1291. doi:10.1111/j.1471-0528.2011.03032.x. hdl:2027.42/86903. PMID 21749626. S2CID 38761694.
  61. ^ Sellors JW (2003). "Chapter 4: An introduction to colposcopy: indications for colposcopy, instrumentation, principles and documentation of results". Colposcopy and treatment of cervical intraepithelial neoplasia: a beginners' manual. International Agency for Research on Cancer. ISBN 978-92-832-0412-1. Archived from the original on 31 January 2019. Retrieved 30 January 2019.
  62. ^ a b c Athanasiou A, Veroniki AA, Efthimiou O, Kalliala I, Naci H, Bowden S, et al. (August 2022). "Comparative effectiveness and risk of preterm birth of local treatments for cervical intraepithelial neoplasia and stage IA1 cervical cancer: a systematic review and network meta-analysis". The Lancet. Oncology. 23 (8): 1097–1108. doi:10.1016/S1470-2045(22)00334-5. PMC 9630146. PMID 35835138.
  63. ^ a b c "Prevention of cervical cancer: what are the risks and benefits of different treatments?". NIHR Evidence (Plain English summary). National Institute for Health and Care Research. 10 November 2023. doi:10.3310/nihrevidence_60599. S2CID 265201829. Archived from the original on 31 May 2024. Retrieved 16 November 2023.
  64. ^ Galaal K, Bryant A, Deane KH, Al-Khaduri M, Lopes AD (December 2011). "Interventions for reducing anxiety in women undergoing colposcopy". The Cochrane Database of Systematic Reviews. 2022 (12) CD006013. doi:10.1002/14651858.cd006013.pub3. PMC 4161490. PMID 22161395.
  65. ^ Mello V, Sundstrom RK (2023). "Cervical Intraepithelial Neoplasia". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 31335091. Archived from the original on 23 February 2023. Retrieved 16 November 2023.
  66. ^ a b "Cervical Dysplasia: Causes, Symptoms, Diagnosis & Treatment". Cleveland Clinic. Archived from the original on 26 October 2016. Retrieved 16 November 2023.
  67. ^ a b "Cancer Research UK website". Archived from the original on 16 January 2009. Retrieved 3 January 2009.
  68. ^ a b c DeMay M (2007). Practical principles of cytopathology. Revised edition. Chicago, IL: American Society for Clinical Pathology Press. ISBN 978-0-89189-549-7.
  69. ^ Salcedo MP, Phoolcharoen N, Schmeler KM (2022). "Intraepithelial neoplasia of the lower genital tract (cervix, vagina, vulva)". Comprehensive Gynecology. Elsevier. pp. 637–647.e2. doi:10.1016/b978-0-323-65399-2.00038-3. ISBN 978-0-323-65399-2.
  70. ^ Garcia A, Hamid O, El-Khoueiry A (6 July 2006). "Cervical Cancer". eMedicine. WebMD. Archived from the original on 9 December 2007. Retrieved 2 December 2007.
  71. ^ Dolinsky C (17 July 2006). "Cervical Cancer: The Basics". OncoLink. Abramson Cancer Center of the University of Pennsylvania. Archived from the original on 18 January 2008. Retrieved 2 December 2007.
  72. ^ "What Is Cervical Cancer?". American Cancer Society. Archived from the original on 3 August 2020. Retrieved 11 September 2017.
  73. ^ "Cervical cancer – Types and grades". Cancer Research UK. Archived from the original on 14 December 2025. Retrieved 20 November 2025.
  74. ^ Turashvili G. "Squamous cell carcinoma and variants". Pathology Outlines. Archived from the original on 21 December 2022. Retrieved 21 December 2022.
  75. ^ Image by Mikael Häggström, MD. Source for caption: Turashvili G. "Cervix – Squamous cell carcinoma and variants". Pathology Outlines. Archived from the original on 21 December 2022. Retrieved 21 December 2022. Last author update: 24 September 2020
  76. ^ Image by Mikael Häggström, MD. Source for caption: Ghosh A, Nirupama M, Padmanabha N, Kini H (2020). "Assessment of p16 and Ki67 Immunohistochemistry Expression in Squamous Intraepithelial Lesion with Cytohistomorphological Correlation". Iran J Pathol. 15 (4): 268–273. doi:10.30699/ijp.2020.112421.2208. PMC 7477676. PMID 32944038.
  77. ^ Mulita F, Iliopoulos F, Kehagias I (September 2020). "A rare case of gastric-type mucinous endocervical adenocarcinoma in a 59-year-old woman". Przeglad Menopauzalny = Menopause Review. 19 (3): 147–150. doi:10.5114/pm.2020.99563. PMC 7573334. PMID 33100952.
  78. ^ Lakhman Y, Aherne EA, Jayaprakasam VS, Nougaret S, Reinhold C (2023). "Staging of Cervical Cancer: A Practical Approach Using MRI and FDG PET". American Journal of Roentgenology. 221 (5): 633–648. doi:10.2214/AJR.23.29003. ISSN 0361-803X. PMC 467038. PMID 37459457.
  79. ^ Bhatla N, Singhal S, Dhamija E, Mathur S, Natarajan J, Maheshwari A (2021). "Implications of the revised cervical cancer FIGO staging system". The Indian Journal of Medical Research. 154 (2): 273–283. doi:10.4103/ijmr.IJMR_4225_20. ISSN 0975-9174. PMC 9131753. PMID 35295012.
  80. ^ Bhatla N, Berek JS, Cuello Fredes M, Denny LA, Grenman S, Karunaratne K, et al. (April 2019). "Revised FIGO staging for carcinoma of the cervix uteri". International Journal of Gynaecology and Obstetrics. 145 (1): 129–135. doi:10.1002/ijgo.12749. PMID 30656645. S2CID 58656013.
  81. ^ a b c d e f g h i "Treatment Options for Cervical Cancer, by Stage". American Cancer Society. 1 July 2025.
  82. ^ Baalbergen A, Veenstra Y, Stalpers L (January 2013). "Primary surgery versus primary radiotherapy with or without chemotherapy for early adenocarcinoma of the uterine cervix". The Cochrane Database of Systematic Reviews. 2021 (1) CD006248. doi:10.1002/14651858.CD006248.pub3. PMC 7387233. PMID 23440805.
  83. ^ Einhorn N, Tropé C, Ridderheim M, Boman K, Sorbe B, Cavallin-Ståhl E (2003). "A systematic overview of radiation therapy effects in cervical cancer (cervix uteri)". Acta Oncologica. 42 (5–6): 546–556. doi:10.1080/02841860310014660. PMID 14596512.
  84. ^ Chemoradiotherapy for Cervical Cancer Meta-analysis Collaboration (CCCMAC) (January 2010). "Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: individual patient data meta-analysis". The Cochrane Database of Systematic Reviews. 2010 (1) CD008285. doi:10.1002/14651858.cd008285. PMC 7105912. PMID 20091664.
  85. ^ Sardain H, Lavoue V, Redpath M, Bertheuil N, Foucher F, Levêque J (August 2015). "Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review" (PDF). European Journal of Surgical Oncology. 41 (8): 975–985. doi:10.1016/j.ejso.2015.03.235. PMID 25922209. S2CID 21911045. Archived (PDF) from the original on 27 July 2020. Retrieved 17 December 2018.
  86. ^ Francoeur AA, Monk BJ, Tewari KS (2025). "Treatment advances across the cervical cancer spectrum". Nature Reviews Clinical Oncology. 22 (3): 182–199. doi:10.1038/s41571-024-00977-w. ISSN 1759-4782.
  87. ^ "Cervical Cancer Treatment – NCI". www.cancer.gov. 13 October 2022. Retrieved 18 February 2026.
  88. ^ Dargent D, Martin X, Sacchetoni A, Mathevet P (April 2000). "Laparoscopic vaginal radical trachelectomy: a treatment to preserve the fertility of cervical carcinoma patients". Cancer. 88 (8): 1877–1882. doi:10.1002/(SICI)1097-0142(20000415)88:8<1877::AID-CNCR17>3.0.CO;2-W. PMID 10760765.
  89. ^ Schlaerth JB, Spirtos NM, Schlaerth AC (January 2003). "Radical trachelectomy and pelvic lymphadenectomy with uterine preservation in the treatment of cervical cancer". American Journal of Obstetrics and Gynecology. 188 (1): 29–34. doi:10.1067/mob.2003.124. PMID 12548192.
  90. ^ Burnett AF (February 2006). "Radical trachelectomy with laparoscopic lymphadenectomy: review of oncologic and obstetrical outcomes". Current Opinion in Obstetrics & Gynecology. 18 (1): 8–13. doi:10.1097/01.gco.0000192968.75190.dc. PMID 16493253. S2CID 22958941.
  91. ^ "Brachytherapy – Mayo Clinic". www.mayoclinic.org. Retrieved 2025-12-01.
  92. ^ a b Rogers L, Siu SS, Luesley D, Bryant A, Dickinson HO (May 2012). "Radiotherapy and chemoradiation after surgery for early cervical cancer". The Cochrane Database of Systematic Reviews. 5 (5) CD007583. doi:10.1002/14651858.cd007583.pub3. PMC 4171000. PMID 22592722.
  93. ^ a b Lin H, Wu CH, Fu HC, Ou YC (1 July 2025). "Recent advances in cervical cancer treatment: Innovations from early-stage to advanced disease". Taiwanese Journal of Obstetrics and Gynecology. 64 (4): 608–615. doi:10.1016/j.tjog.2025.04.006. ISSN 1028-4559.
  94. ^ Nama V, Angelopoulos G, Twigg J, Murdoch JB, Bailey J, Lawrie TA (October 2018). "Type II or type III radical hysterectomy compared to chemoradiotherapy as a primary intervention for stage IB2 cervical cancer". The Cochrane Database of Systematic Reviews. 2018 (10) CD011478. doi:10.1002/14651858.cd011478.pub2. PMC 6516889. PMID 30311942.
  95. ^ a b c d e Backer-Meurke S, Agyemang A, Castellano T, Jernigan A (15 July 2025). "Management of Recurrent and Metastatic Cervical Cancer: A Review of Current Practice". Oncol AMJ Oncology 2.1 2025. 2 (1): 126–138. doi:10.33590/oncolamj/XRET2117. ISSN 2054-619X.
  96. ^ Falcetta FS, Medeiros LR, Edelweiss MI, Pohlmann PR, Stein AT, Rosa DD (November 2016). "Adjuvant platinum-based chemotherapy for early stage cervical cancer". The Cochrane Database of Systematic Reviews. 11 (11) CD005342. doi:10.1002/14651858.CD005342.pub4. PMC 4164460. PMID 27873308.
  97. ^ "Immunotherapy for Cervical Cancer". American Cancer Society. 1 July 2025. Retrieved 24 February 2026.
  98. ^ a b "Tivdak". European Medicines Agency (EMA). 31 January 2025. Retrieved 24 February 2026.
  99. ^ "Seagen and Genmab Announce FDA Accelerated Approval for Tivdak (tisotumab vedotin-tftv) in Previously Treated Recurrent or Metastatic Cervical Cancer". Seagen. 20 September 2021. Archived from the original on 11 May 2022. Retrieved 20 September 2021 – via Business Wire.
  100. ^ a b Dhakal K, Chen C, Wang P, Mboineki JF, Adhikari B (28 May 2024). "Existing psychological supportive care interventions for cervical cancer patients: a systematic review and meta-analysis". BMC Public Health. 24 (1): 1419. doi:10.1186/s12889-024-18634-3. ISSN 1471-2458. PMC 11131189. PMID 38802848.
  101. ^ Mello V, Sundstrom RK (January 2022). "Cervical Intraepithelial Neoplasia.". StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. PMID 31335091. Archived from the original on 13 December 2021. Retrieved 27 February 2022.
  102. ^ Gennigens C, Jerusalem G, Lapaille L, De Cuypere M, Streel S, Kridelka F, et al. (2022). "Recurrent or primary metastatic cervical cancer: current and future treatments". ESMO open. 7 (5) 100579. doi:10.1016/j.esmoop.2022.100579. ISSN 2059-7029. PMC 9588874. PMID 36108558.
  103. ^ Cohen CM, Wentzensen N, Castle PE, Schiffman M, Zuna R, Arend RC, et al. (1 December 2022). "Racial and Ethnic Disparities in Cervical Cancer Incidence, Survival, and Mortality by Histologic Subtype". Journal of Clinical Oncology. 41 (5). ASCO Publications: 1059–1068. doi:10.1200/JCO.22.01424. PMC 9928618. PMID 36455190.
  104. ^ "Cervical cancer statistics and prognosis". Cancer Research UK. Archived from the original on 20 May 2007. Retrieved 24 March 2007.
  105. ^ a b Nygård M (June 2011). "Screening for cervical cancer: when theory meets reality". BMC Cancer. 11 240. doi:10.1186/1471-2407-11-240. PMC 3146446. PMID 21668947.
  106. ^ Muliira RS, Salas AS, O'Brien B (2016). "Quality of Life among Female Cancer Survivors in Africa: An Integrative Literature Review". Asia-Pacific Journal of Oncology Nursing. 4 (1): 6–17. doi:10.4103/2347-5625.199078. PMC 5297234. PMID 28217724.
  107. ^ Dutta T, Meyerson B, Agley J (2018). "African cervical cancer prevention and control plans: A scoping review". Journal of Cancer Policy. 16: 73–81. doi:10.1016/j.jcpo.2018.05.002. S2CID 81552501.
  108. ^ "Chemotherapy for Cervical Cancer". www.cancer.org. American Cancer Society. 28 June 2024. Retrieved 24 October 2024.
  109. ^ a b Majeed H, Gupta V (14 August 2023). Adverse Effects of Radiation Therapy. StatPearls Publishing LLC. PMID 33085406. NBK563259. Archived from the original on 4 February 2025. Retrieved 24 October 2024.
  110. ^ Schmitt LG, Amarnath SR (1 September 2023). "Late Effects of Pelvic Radiation Therapy in the Female Patient: A Comprehensive Review". Applied Radiation Oncology. 2023 (3): 13–24. doi:10.37549/ARO-D-23-00016. Retrieved 16 October 2024.
  111. ^ Huh JW, Tanksley J, Chino J, Willett CG, Dewhirst MW (1 July 2020). "Long-term Consequences of Pelvic Irradiation: Toxicities, Challenges, and Therapeutic Opportunities with Pharmacologic Mitigators". Clinical Cancer Research. 26 (13): 3079–3090. doi:10.1158/1078-0432.CCR-19-2744. ISSN 1078-0432. PMID 32098770. Archived from the original on 12 October 2024. Retrieved 24 October 2024.
  112. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. Archived from the original on 11 November 2009. Retrieved 11 November 2009.
  113. ^ Cordeiro CN, Gemignani ML (March 2017). "Gynecologic Malignancies in Pregnancy: Balancing Fetal Risks With Oncologic Safety". Obstetrical & Gynecological Survey. 72 (3): 184–193. doi:10.1097/OGX.0000000000000407. PMC 5358514. PMID 28304416.
  114. ^ "WHO adds an HPV vaccine for single-dose use". World Health Organization. 4 October 2024. Archived from the original on 4 October 2024. Retrieved 5 October 2024.
  115. ^ "Eliminating Cervical Cancer in Nigeria: How Awareness, Infrastructure, and Government Support Can Make a Difference – My Daily News Usa". 4 April 2023. Archived from the original on 15 April 2023. Retrieved 15 April 2023.
  116. ^ Sahana DU (4 April 2023). "Eliminating Cervical Cancer in Nigeria: How Awareness, Infrastructure, and Government Support Can Make a Difference". My Daily News Usa. Archived from the original on 15 April 2023. Retrieved 15 April 2023.
  117. ^ a b "Global partners cheer progress towards eliminating cervical cancer and underline challenges". World Health Organization. 17 November 2023. Archived from the original on 7 October 2024. Retrieved 6 October 2024.
  118. ^ "Cervical cancer in Australia statistics". Australian Government – Cancer Australia. 18 August 2022. Archived from the original on 21 January 2023. Retrieved 21 January 2023.
  119. ^ "National Cervical Screening Program monitoring report 2022, Summary". Australian Institute of Health and Welfare. December 2022. Retrieved 21 January 2023.
  120. ^ "Incidence and mortality rates". January 1900. Archived from the original on 12 September 2009.
  121. ^ National Cancer Registry Programme under Indian Council of Medical Research Reports
  122. ^ "Plunes HealthCare – Surgery Experience Made Easy | Upto 50% Off". www.plunes.com. Archived from the original on 14 December 2023. Retrieved 10 January 2024.
  123. ^ Krishnatreya M, Kataki AC, Sharma JD, Nandy P, Gogoi G (2015). "Association of educational levels with survival in Indian patients with cancer of the uterine cervix". Asian Pacific Journal of Cancer Prevention. 16 (8): 3121–3123. doi:10.7314/apjcp.2015.16.8.3121. PMID 25921107.
  124. ^ G C B, G C A (2025). "Other countries should copy Nepal's approach to tackling cervical cancer". Nature. 638 (8052): 891. Bibcode:2025Natur.638..891G. doi:10.1038/d41586-025-00589-z. ISSN 1476-4687. PMID 40000865.
  125. ^ "Cervical Cancer statistics". Canadian Cancer Society. May 2022. Archived from the original on 21 January 2023. Retrieved 21 January 2023.
  126. ^ a b Armstrong EP (April 2010). "Prophylaxis of cervical cancer and related cervical disease: a review of the cost-effectiveness of vaccination against oncogenic HPV types". Journal of Managed Care Pharmacy. 16 (3): 217–230. doi:10.18553/jmcp.2010.16.3.217. PMC 10437588. PMID 20331326. S2CID 14373353.
  127. ^ "The cancer we can eliminate – WHO/Europe urges Member States to consign cervical cancer to history". www.who.int. Archived from the original on 21 January 2023. Retrieved 21 January 2023.
  128. ^ "Cervical cancer statistics". Cancer Research UK. Retrieved 7 March 2026.
  129. ^ zur Hausen H (May 2002). "Papillomaviruses and cancer: from basic studies to clinical application". Nature Reviews. Cancer. 2 (5): 342–350. Bibcode:2002NatRC...2..342Z. doi:10.1038/nrc798. PMID 12044010. S2CID 4991177.
  130. ^ Beachler DC, Kreimer AR, Schiffman M, Herrero R, Wacholder S, Rodriguez AC, et al. (January 2016). "Multisite HPV16/18 Vaccine Efficacy Against Cervical, Anal, and Oral HPV Infection". Journal of the National Cancer Institute. 108 (1) djv302. doi:10.1093/jnci/djv302. PMC 4862406. PMID 26467666.
  131. ^ Kreimer AR, Herrero R, Sampson JN, Porras C, Lowy DR, Schiller JT, et al. (August 2018). "Evidence for single-dose protection by the bivalent HPV vaccine-Review of the Costa Rica HPV vaccine trial and future research studies". Vaccine. 36 (32 Pt A): 4774–4782. doi:10.1016/j.vaccine.2017.12.078. PMC 6054558. PMID 29366703.
  132. ^ Menczer J (February 2003). "The low incidence of cervical cancer in Jewish women: has the puzzle finally been solved?". The Israel Medical Association Journal. 5 (2): 120–123. PMID 12674663. Archived from the original on 8 December 2015. Retrieved 28 November 2015.
  133. ^ Syverton JT, Berry GP (1935). "Carcinoma in the Cottontail Rabbit Following Spontaneous Virus Papilloma (Shope)". Experimental Biology and Medicine. 33 (3): 399–400. doi:10.3181/00379727-33-8386P. S2CID 88311393.
  134. ^ IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2007). "Studies of Animal Papillomaviruses". Human Papillomaviruses. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 90. Lyon, France: International Agency for Research on Cancer. Archived from the original on 14 December 2024. Retrieved 13 January 2024.
  135. ^ Heins HC, Dennis EJ, Pratthomas HR (October 1958). "The possible role of smegma in carcinoma of the cervix". American Journal of Obstetrics and Gynecology. 76 (4): 726–33, discussion 733–5. doi:10.1016/0002-9378(58)90004-8. PMID 13583012.
  136. ^ Alexander ER (June 1973). "Possible etiologies of cancer of the cervix other than herpesvirus". Cancer Research. 33 (6): 1485–1490. PMID 4352386.
  137. ^ Rosenblatt A, de Campos Guidi HG (6 August 2009). Human Papillomavirus: A Practical Guide for Urologists. Springer Science & Business Media. ISBN 978-3-540-70974-9.
  138. ^ Dürst M, Gissmann L, Ikenberg H, zur Hausen H (June 1983). "A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions". Proceedings of the National Academy of Sciences of the United States of America. 80 (12): 3812–3815. Bibcode:1983PNAS...80.3812D. doi:10.1073/pnas.80.12.3812. PMC 394142. PMID 6304740..
  139. ^ Lowy DR, Schiller JT (May 2006). "Prophylactic human papillomavirus vaccines". The Journal of Clinical Investigation. 116 (5): 1167–1173. doi:10.1172/JCI28607. PMC 1451224. PMID 16670757.
  140. ^ McNeil C (April 2006). "Who invented the VLP cervical cancer vaccines?". Journal of the National Cancer Institute. 98 (7): 433. doi:10.1093/jnci/djj144. PMID 16595773.
  141. ^ "WHO rolls out plan to rid world of cervical cancer, saving millions of lives". UN News. 16 November 2020. Archived from the original on 26 November 2020. Retrieved 27 November 2020.
  142. ^ "Global strategy to accelerate the elimination of cervical cancer as a public health problem". World Health Organization. 17 November 2020. Archived from the original on 26 January 2026. Retrieved 6 October 2024.
  143. ^ Cancer Institute NSW (2013). "Information about cervical screening for Aboriginal women". NSW Government. Archived from the original on 11 April 2013.
  144. ^ a b Romano MA (17 October 2011). "Aboriginal cervical cancer rates parallel health inequity". Science Network Western Australia. Archived from the original on 14 May 2013.
  145. ^ Australian Cervical Cancer Foundation. "Vision and Mission". Australian Cervical Cancer Foundation. Archived from the original on 12 May 2013.
  146. ^ Australian Cervical Cancer Foundation. "Our People". Australian Cervical Cancer Foundation. Archived from the original on 12 May 2013.
  147. ^ Bradford G (16 October 2006). "Janette Howard speaks on her battle with cervical cancer". Australian Broadcasting Corporation. Archived from the original on 3 November 2012.
  148. ^ Tiro JA, Meissner HI, Kobrin S, Chollette V (February 2007). "What do women in the U.S. know about human papillomavirus and cervical cancer?". Cancer Epidemiology, Biomarkers & Prevention. 16 (2): 288–294. doi:10.1158/1055-9965.EPI-06-0756. PMID 17267388.
  149. ^ Singh GK, Miller BA, Hankey BF, Edwards BK (September 2004). "Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975–2000". Cancer. 101 (5): 1051–1057. doi:10.1002/cncr.20467. PMID 15329915. S2CID 26033629.
  150. ^ Peterson CE, Silva A, Goben AH, Ongtengco NP, Hu EZ, Khanna D, et al. (December 2021). "Stigma and cervical cancer prevention: A scoping review of the U.S. literature". Prev Med. 153 106849. doi:10.1016/j.ypmed.2021.106849. PMID 34662598. S2CID 239027566. Archived from the original on 1 December 2023. Retrieved 16 November 2023.
  151. ^ "As a trans man, do I need to get screened for cervical cancer?". Canadian Cancer Society. Archived from the original on 21 January 2023. Retrieved 21 January 2023.
  152. ^ "Should trans men have cervical screening tests?". nhs.uk. 27 June 2018. Archived from the original on 3 January 2023. Retrieved 21 January 2023.
  153. ^ Peitzmeier SM, Bernstein IM, McDowell MJ, Pardee DJ, Agénor M, Alizaga NM, et al. (December 2020). "Enacting power and constructing gender in cervical cancer screening encounters between transmasculine patients and health care providers". Culture, Health & Sexuality. 22 (12): 1315–1332. doi:10.1080/13691058.2019.1677942. PMC 7188565. PMID 31661659.
  154. ^ Potter J, Peitzmeier SM, Bernstein I, Reisner SL, Alizaga NM, Agénor M, et al. (December 2015). "Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians". Journal of General Internal Medicine. 30 (12): 1857–1864. doi:10.1007/s11606-015-3462-8. PMC 4636588. PMID 26160483.
  155. ^ Agénor M, Peitzmeier SM, Bernstein IM, McDowell M, Alizaga NM, Reisner SL, et al. (October 2016). "Perceptions of cervical cancer risk and screening among transmasculine individuals: patient and provider perspectives". Culture, Health & Sexuality. 18 (10): 1192–1206. doi:10.1080/13691058.2016.1177203. PMID 27142466. S2CID 22036018.
  156. ^ "I'm trans or non-binary, does this affect my cancer screening?". Cancer Research UK. 10 October 2019. Archived from the original on 25 December 2022. Retrieved 21 January 2023.
  157. ^ "As a trans woman, do I need to get screened for cervical cancer?". Canadian Cancer Society. Archived from the original on 12 September 2022. Retrieved 21 January 2023.
  158. ^ Labanca T, Mañero I, Pannunzio M (December 2020). "Transgender patients: considerations for routine gynecologic care and cancer screening". International Journal of Gynecological Cancer. 30 (12): 1990–1996. doi:10.1136/ijgc-2020-001860. PMID 33109526. S2CID 225096075.
  159. ^ "Causes of cervical cancer". nhs.uk. 20 October 2017. Archived from the original on 23 January 2023. Retrieved 21 January 2023.

Further reading

Wikimedia Commons has media related to Cervical cancer.
This article is issued from Wikipedia. The text is available under Creative Commons Attribution-Share Alike 4.0 unless otherwise noted. Additional terms may apply for the media files.