Comprehensive care of the carcinoma of the uterine cervix

Cancer of the uterine cervix is a major world health problem for women. Yearly around half a million new cases are diagnosed with cervical cancer having leaded nearly 300,000 deaths in 2018 globally. In developed countries epidemiological data is improving due to the vaccination policy against “high risk” human papilloma viruses (hrHPV) and the population-based screening programs by cytology or hrHPV-testing. However, in developing regions the incidence and mortality data are still dismal. Precancerous lesions and early-stage cervical cancer can be cured solely by surgical approach. Pathological risk factors will determine the need of postoperative radio- or chemoradiotherapy. In advanced-stage disease chemoradiotherapy or systemic therapy are the available options. As a considerable part of the patients are young female, there are some special issues to be faced with like the desire of fertility-sparing or cervical cancer diagnosed in pregnancy. Clinically occult cervical carcinoma recognized after simple hysterectomy is another complex therapeutic field. In modern oncology, the biological agents have also emerged in the therapeutic field of advanced cases: bevacizumab combined with cisplatin and paclitaxel as first line therapy; and pembrolizumab as second line option for tumors with microsatellite instability-high (MSI-H)/mismatch repair deficiency (dMMR) or for tumors express PD-L1 (Combined Positive Score [CPS] ≥1.) The present work provides a short summary of the current literature about the screening, staging, comprehensive management and follow-up of uterine cervical cancer.