Cervical cancer and intraepithelial neoplasia

Abstract

Cervical cancer is the second most frequent malignancy in women. Infection with high-risk papillomaviruses causes cervical cancer and can be prevented by vaccination. Secondary prevention using cytology and/or human papillomavirus testing successfully decreases the incidence of cancer by detection of cervical intraepithelial neoplasia (CIN). Colposcopy is used to locate CIN and to assure preservation of healthy tissue when removing CIN. Diagnosis of CIN and cancer is based on histopathology. In invasive disease, imaging techniques such as MRI or PET-CT help to assess the locoregional extent of the disease. For staging, the FIGO and TNM system are applied. Laparoscopic staging, especially of lymph nodes, is most reliable for the assessment of the biology of invasive disease. Disease-based treatment of women with cervical cancer is an interdisciplinary effort. Nerve sparing, fertility sparing, and lymph node sparing are recent surgical concepts which lead to improved quality of life for women diagnosed with early-stage disease. In advanced-stage disease, laparoscopic staging followed by primary chemoradiation is the treatment of choice. Copyright © 2012 S. Karger AG, Basel.