EC Gynaecology

Revisiting the cervical cancer management

Besides the great strides of advances in the diagnosis and treatment modality, the burden (including financial) of cervical cancer remains high in many parts of the world, and especially in economically compromised countries, the incidence and mortality of this cancer remain much higher than the threshold calculations set by the WHO initiative on cervical cancer eradication. Worldwide, there exists substantial geographical and socioeconomic disparities in cervical cancer, with a clear gradient trend of increasing incidence in countries with lower levels of economic human development. As per the GLOBCAN report 2020, worldwide, there are estimated 604127 estimated cervical cancer cases and over 341831 deaths, with a correlated age-standardised incidence of 13.3 cases per 100000 women-years and mortality rate of 7.2 deaths per 100 000 women-years [1]. Globally there are over 200 known types of human papillomavirus (HPV) genomes: a main culprit and causative virus of cervical cancer. The HPV viral strains are broadly classified as either "high-risk" or "low-risk" based on their association with severity of disease conditions. High-risk HPV strains are associated with increased risk of developing certain cancers, including cervical, anal, vaginal, vulvar, penile, and some oral cancers. The most commonly diagnosed high-risk HPV types are HPV-16 and HPV-18, which are responsible for causation of the majority of cervical cancer cases. On the other hand, low-risk HPV strains are generally not associated with cancer but can cause conditions such as genital warts etc. The recent findings clearly suggest the involvement of HPV infection in neck and head squamous cell carcinoma, esophageal cancer, cervical cancer, head and neck cancer, brain and lung tumours. These independent traditional risk factors, along with various clinical outcomes, and increased prevalence among certain human populations and geographical regions have inspired the interest of scientific community in HPV research. Although the mode of HPVs transmission is poorly understood, however the recent data reported the vertical transmission of HPVs [2].

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