Cervical Cancer
Clinical Management Guidelines

Human papillomavirus (HPV) is considered to be the most important factor contributing to the development of cervical cancer. Other risk factors include history of sexual intercourse at a young age, multiple sexual partners, sexually transmitted diseases, smoking, partners who have had multiple sexual partners, history of squamous dysplasia of the cervix, vagina, or vulva, or immunosuppression.

Signs and symptoms of early disease include watery vaginal discharge, intermittent spotting, and postcoital bleeding, although the symptoms may go unrecognised by patients. Accurate diagnosis may be made with cytology screening, colposcopically-directed biopsy, biopsy of a gross or palpable lesion, or cone biopsy to detect microinvasion or early stage carcinoma.

The 2 major histological types of invasive cervical carcinoma are squamous cell carcinomas and adenocarcinomas. Management of early cervical carcinoma involves surgery or radiation therapy, with or without chemotherapy.

The Committee on Practice Bulletins of the American College of Obstetricians and Gynecologists (ACOG) has issued guidelines on diagnosis and treatment of cervical cancer. The guidelines are summarised in this article.