Treating Cervical Cancer

Cervical cancer is the most common gynecologic malignancy in Taiwan. The incidence of cervical cancer is 51.88/100,000 women in 20021. Over 99% of cervical cancers are caused by the high-risk group of human papillomavirus (HPV)2, which includes types 16 and 18 that are responsible for over 70% of cervical cancer. Quadrivalent (Gardasil®; Merck & Co., NJ, USA) and bivalent (Cervarix®; GlaxoSmithKline, London, UK) HPV vaccines are recently available treatments for prevention of cervical infection of the two high-risk HPV types before the onset of pre-cancer lesion (cervical intraepithelial neoplasm [CIN]). Cervical cancer is also a slowly progressing local disease, which occurs 5–30 years after the development of CIN lesions. CIN lesions can be detected by Papanicolaou smear and treated with local excision procedure or simple hysterectomy. Unfortunately, if CIN lesions develop into invasive cancer, the treating modalities become more complicated, and usually at a sacrifice to the quality of life of these cervical cancer patients. We would like to review the modern trends in the treatment of invasive cervical cancer.