Cancer of the uterine cervix: a narrative review

Uterine cervical cancer remains a major global public health challenge. This narrative review aims to provide a comprehensive overview of the epidemiology, pathogenesis, histological classification, screening, diagnostic approaches, treatment, and prevention of cervical cancer.

We searched MEDLINE, Google Scholar, and Scopus for publications in English without date limits and using the search terms "cervical cancer" AND "human papillomavirus" AND "screening" OR "staging" OR "diagnosis" OR "microbiome" OR "treatment" OR "HPV DNA test". We also used references from the texts retrieved via our literature searches.

Cervical cancer has several histological types, with squamous cell carcinoma being the most common, followed by adenocarcinoma. Human papillomavirus (HPV) is considered the main, but not exclusive, player in oncogenesis. The mechanisms of cancer development are well understood, especially the roles of E6 and E7. The vaginal microbiome is an essential cofactor in this process. Prevention can be via either primary (vaccination) or secondary (screening) intervention. The Papanicolaou test and HPV DNA test are the primary screening tools. Index screening cases must undergo colposcopy and biopsy to identify high-grade squamous intraepithelial lesions (true precancerous lesions), and such cases must be treated according to guidelines. However, if an invasive cancer occurs, it must be staged to define the treatment.

The pathogenesis of cervical cancer has been studied extensively, and various well-defined forms of prevention have been devised. However, it is still prevalent, especially in developing countries. The present review is vital for updating knowledge and helping in the fight against this disease that kills so many women.