Most of these cancers stem from infection with the human papillomavirus, although other host factors affect neoplastic progression following initial infection. Compared with other gynecologic malignancies, cervical cancer develops in a younger population of women. Thus, screening for this neoplasia with Pap smear sampling typically begins in adolescence or young adulthood. Most early cancers are asymptomatic, whereas symptoms of advancing cervical cancer may include bleeding, watery discharge, and signs associated with venous, lymphatic, neural, or ureteral compression. Diagnosis of cervical cancer usually follows colposcopic examination and histologic evaluation of cervical biopsies.
Worldwide, cervical cancer is common, and ranks second among all malignancies for women (Parkin, 2005). In 2002, an estimated 493,000 new cases were identified globally and 274,000 deaths were recorded. In general, higher incidences are found in developing countries, and these countries contribute 83 percent of reported cases annually. Economically advantaged countries have significantly lower cervical cancer rates, and add only 3.6 percent of new cancers. This incidence disparity highlights successes achieved by cervical cancer screening programs in which Papanicolaou (Pap) smears are regularly obtained. There is considerable variation of incidences, screening, diagnosis, and treatment statistics throughout the world, but the trend of the disease is considered to be resulting mainly from financial and cultural characteristics affecting access to screening and treatment. The age at which cervical cancer develops is in general earlier than that of other gynecologic malignancies, and the median age at diagnosis ranges from 40 to 59 years. In women aged 20 to 39 years, cervical cancer is the second leading cause of cancer deaths.
There are data that indicate the cervical cancer is a preventable disease, and in developed countries, such as, in the United States, where well established screening programmes exist, it is estimated that 30% of cervical cancer cases will occur in women who have never had a Pap test. In developing countries, this percentage approaches 60%. It is a matter to be reckoned that in spite of these statistics, the worldwide incidence of invasive disease is decreasing, and cervical cancer is being diagnosed earlier, leading to better survival rates. Worldwide data indicate that the mean age for cervical cancer is 47 years, and the distribution of cases is bimodal, with peaks at 35 to 39 years and 60 to 64 years of age.
There are numerous risk factors for cervical cancer: young age at first intercourse (