Cervical Cancer: Etiology, Pathogenesis, Treatment, and Future Vaccines

Cervical cancer is a sexually transmitted disease caused by the human papillomavirus (HPV), especially HPV-16 and -18. Of the half million new cases of cervical cancer reported yearly, 20% occur in India. Mass cancer screening programs to detect and treat cervical cancer and its precursor lesions are not available in India and most other developing countries because of the lack of resources. Curative and palliative treatments are not the same for all patients with cervical cancer because the result depends on the immunological response of the patient. This article describes the natural history of cervical carcinogenesis and the rational behind various modalities of prevention and treatment for the practising gynecological oncologist. Prophylactic vaccines against HPV-16 and -18 and therapeutic vaccines against cervical cancers should be able to overcome the logistical problems that now exist to screen, diagnose and treat cervical cancer and its precursor lesions.