Cervical cancer remains one of the most prevalent gynecologic cancers in the world. According to the most recent data, it ranks 14th among all malignancies and 4th among women globally. The primary and secondary emphasis of cervical cancer intervention is primary and secondary prevention.
Primary prevention and screening are the most effective techniques for reducing cervical cancer incidence and mortality. In the US and other developing nations, the majority of screening and diagnostic efforts focus on early detection of HPV lesions by HPV testing and Pap smears.
Although HPV testing is not advised for women under 30 years of age, the United States Preventive Services Task Force recommends that low-risk younger women begin screening with Pap smears at age 21. Women at risk are recommended to continue these tests until the age of 65.
Based on earlier results and the use of these tests and more recent guidelines suggest screening intervals of 3 to 5 years. Because cervical cancer is caused by a STI, it is avoidable. Education, consistent screenings, and effective interventions can reduce the burden of this disease. Just like other diseases and cancers,
In the United States, African American women have a significantly higher cervical cancer mortality rate. Since 2006, vaccines to help prevent cervical cancer have been accessible. Vaccination can reduce cancer mortality rates in nations with limited resources which don’t have the resources for regular screenings and have higher fatality rates.
Epidemiology
More than 500,000 new instances of cervical cancer are diagnosed annually on a global scale. Cervical Cancer claims around 250,000 lives every year. Women in areas with scarce resources, Hispanics, and African American women have lower rates of evidence-based care and a significantly higher death rate than women in other demographic groups. HPV, the virus which causes cervical cancer is an STI.
Mortality rate is much higher in women who have not been screened in the past 5 years for cervical cancer. The lack of regular follow-ups after being diagnosed with a precancerous lesion is another factor that drives up the mortality rate. Ongoing trends suggest that women with highest risk of mortality are perhaps less likely to get vaccinated.
Anatomy
Pathophysiology
The causal agent of cervical cancer is HPV. Over 75% of cases are significantly related to high-risk HPV 16 and 18. Although more than 500,000 cases of HPV are diagnosed annually, most cases are low-grade infections that cure on their own within two years.
Etiology
According to current research, Human Papillomavirus (HPV) is present in most sexually active individuals sometime in their lives. There are around 130 recognized kinds of HPV, 20 of which have been linked to cancer.
Cervical dysplasia rates associated with HPV are solely known in women, as men are not examined outside of study protocols. HPV 16 and 18 are the most prevalent types of HPV detected in invasive cervical cancer.
Most cases of high-risk HPV occur in women under the age of 25 — various studies suggest that most cases of HPV do not lead to cancer in women aged above 25. Nevertheless, co-infection may reduce the likelihood of spontaneous clearance and cancer progression.
Some factors which increase the risk for Cervical cancer and contracting HPV are:
Use of oral contraceptives
Herpes Simplex Virus
HIV
Other genital illnesses like chlamydia
More than 1 sexual partner
Smoking
HPV is transmitted through skin-to-skin contact, which includes sexual contact, hand-to-genital organ touch, and oral sex.
Genetics
Prognostic Factors
Vaccines are around 90% effective against HPV. HPV patients who have been diagnosed late have an exponentially higher possibility of developing cervical cancer than individuals who are screened regularly, so inconsistent screening is a significant risk factor for cervical cancer.
According to the SEER database, 5-year survival rates are determined by the extent of the spread of cancer in the body. If the cancer is localized the survival rate is 92%; if the cancer has spread to lymph nodes near the uterus and cervix it is 58%; and it’s approximately 18% when distant parts of the body and organs near the cervix have been affected by the cancer.
Factors which affect significantly affect outcomes in patients with cervical cancer are:
Recommended for patients whose cervical cancer has spread to other organs or has returned after chemotherapy
2 mg/kg intravenous every three weeks; for patients ≥100 kg, not more than 200 mg/dose
Continue until the disease worsens or the toxicity becomes intolerable Dosage Modifications
Schedule for dose decrease
First reduced dose: 1.3 mg/kg
The second reduced dose: 0.9 mg/kg
If unable to handle 0.9 mg/kg, stop using it permanently Keratitis
Any instance of superficial punctate keratitis (SPK): supervise Perforation or ulcerative keratitis: Immediately stop using
superficial keratitis with confluence
Initial occurrence: Delay in starting at the next lower dose until SPK or normal
Second occurrence: Stop forever Conjunctival ulceration
Initial incidence: Delay until full conjunctival reepithelialization has occurred; then, resume at the following lower dose
Second incidence: Stop forever
scarring on the cornea or conjunctiva or symblepharon
Any symblepharon or scarring: Immediately stop using
Conjunctivitis and other ocular adverse reactions
any incidence in grade 1: monitor
Grade 2-4
First incidence in Grade 2: Delay until Grade 1 and then continue at the same dose
Grade 2, second incidence: Delay until Grade 1, restart at the subsequent lower dose, and if Grade 1 does not improve, permanently quit
Grade 2, third offence: Stop forever
Grades 3 or 4: Discontinue forever Peripheral neuropathy
Grade 2, beginning or severity of an existing condition: Hold off until Grade 1 and resume at the following lower dose
Grades 3 or 4: Discontinue forever Hemorrhage
Any CNS or pulmonary grade: Permanently stop
Any other place
Grade 2: Delay until issue is rectified; then, restart dose
Grade 3, initial event: Delay resume at same dose until resolved
Grade 3, second event, or grade 4: Permanently stop Pneumonitis
For persistent or recurring pneumonitis in Grade 2, wait until Grade 1 and then think about starting again at the following lower dose
Grade 3 or 4: Discontinue forever Renal impairment
There is no need to alter the dosage for creatinine clearance 30 to 90 ml/min
End-stage renal disease (ESRD) with or without dialysis or creatinine clearance 15–30 ml/min: Unknown pharmacokinetics Hepatic impairment
Mild: Carefully watch for side effects; do not change the beginning dose
Moderate to severe: Do not use Dosing consideration
Ocular examination: Do an eye examination, including slit lamp testing for visual acuity, at baseline, before each dose, and as clinically necessary
Topical corticosteroid eye drops: After examination with a slit lamp, determine the initial prescription and all renewals of any corticosteroid medication
Use topical ocular vasoconstrictor drops to each eye just prior to each infusion
Topical lubricating ophthalmic drops: Inform patients to use them throughout the course of treatment and for 30 days following the last dosage
Contact lenses: For the whole course of treatment, advise patients to refrain from wearing contact lenses unless instructed to do so by their eye doctor
Cervical cancer remains one of the most prevalent gynecologic cancers in the world. According to the most recent data, it ranks 14th among all malignancies and 4th among women globally. The primary and secondary emphasis of cervical cancer intervention is primary and secondary prevention.
Primary prevention and screening are the most effective techniques for reducing cervical cancer incidence and mortality. In the US and other developing nations, the majority of screening and diagnostic efforts focus on early detection of HPV lesions by HPV testing and Pap smears.
Although HPV testing is not advised for women under 30 years of age, the United States Preventive Services Task Force recommends that low-risk younger women begin screening with Pap smears at age 21. Women at risk are recommended to continue these tests until the age of 65.
Based on earlier results and the use of these tests and more recent guidelines suggest screening intervals of 3 to 5 years. Because cervical cancer is caused by a STI, it is avoidable. Education, consistent screenings, and effective interventions can reduce the burden of this disease. Just like other diseases and cancers,
In the United States, African American women have a significantly higher cervical cancer mortality rate. Since 2006, vaccines to help prevent cervical cancer have been accessible. Vaccination can reduce cancer mortality rates in nations with limited resources which don’t have the resources for regular screenings and have higher fatality rates.
More than 500,000 new instances of cervical cancer are diagnosed annually on a global scale. Cervical Cancer claims around 250,000 lives every year. Women in areas with scarce resources, Hispanics, and African American women have lower rates of evidence-based care and a significantly higher death rate than women in other demographic groups. HPV, the virus which causes cervical cancer is an STI.
Mortality rate is much higher in women who have not been screened in the past 5 years for cervical cancer. The lack of regular follow-ups after being diagnosed with a precancerous lesion is another factor that drives up the mortality rate. Ongoing trends suggest that women with highest risk of mortality are perhaps less likely to get vaccinated.
The causal agent of cervical cancer is HPV. Over 75% of cases are significantly related to high-risk HPV 16 and 18. Although more than 500,000 cases of HPV are diagnosed annually, most cases are low-grade infections that cure on their own within two years.
According to current research, Human Papillomavirus (HPV) is present in most sexually active individuals sometime in their lives. There are around 130 recognized kinds of HPV, 20 of which have been linked to cancer.
Cervical dysplasia rates associated with HPV are solely known in women, as men are not examined outside of study protocols. HPV 16 and 18 are the most prevalent types of HPV detected in invasive cervical cancer.
Most cases of high-risk HPV occur in women under the age of 25 — various studies suggest that most cases of HPV do not lead to cancer in women aged above 25. Nevertheless, co-infection may reduce the likelihood of spontaneous clearance and cancer progression.
Some factors which increase the risk for Cervical cancer and contracting HPV are:
Use of oral contraceptives
Herpes Simplex Virus
HIV
Other genital illnesses like chlamydia
More than 1 sexual partner
Smoking
HPV is transmitted through skin-to-skin contact, which includes sexual contact, hand-to-genital organ touch, and oral sex.
Vaccines are around 90% effective against HPV. HPV patients who have been diagnosed late have an exponentially higher possibility of developing cervical cancer than individuals who are screened regularly, so inconsistent screening is a significant risk factor for cervical cancer.
According to the SEER database, 5-year survival rates are determined by the extent of the spread of cancer in the body. If the cancer is localized the survival rate is 92%; if the cancer has spread to lymph nodes near the uterus and cervix it is 58%; and it’s approximately 18% when distant parts of the body and organs near the cervix have been affected by the cancer.
Factors which affect significantly affect outcomes in patients with cervical cancer are:
Recommended for patients whose cervical cancer has spread to other organs or has returned after chemotherapy
2 mg/kg intravenous every three weeks; for patients ≥100 kg, not more than 200 mg/dose
Continue until the disease worsens or the toxicity becomes intolerable Dosage Modifications
Schedule for dose decrease
First reduced dose: 1.3 mg/kg
The second reduced dose: 0.9 mg/kg
If unable to handle 0.9 mg/kg, stop using it permanently Keratitis
Any instance of superficial punctate keratitis (SPK): supervise Perforation or ulcerative keratitis: Immediately stop using
superficial keratitis with confluence
Initial occurrence: Delay in starting at the next lower dose until SPK or normal
Second occurrence: Stop forever Conjunctival ulceration
Initial incidence: Delay until full conjunctival reepithelialization has occurred; then, resume at the following lower dose
Second incidence: Stop forever
scarring on the cornea or conjunctiva or symblepharon
Any symblepharon or scarring: Immediately stop using
Conjunctivitis and other ocular adverse reactions
any incidence in grade 1: monitor
Grade 2-4
First incidence in Grade 2: Delay until Grade 1 and then continue at the same dose
Grade 2, second incidence: Delay until Grade 1, restart at the subsequent lower dose, and if Grade 1 does not improve, permanently quit
Grade 2, third offence: Stop forever
Grades 3 or 4: Discontinue forever Peripheral neuropathy
Grade 2, beginning or severity of an existing condition: Hold off until Grade 1 and resume at the following lower dose
Grades 3 or 4: Discontinue forever Hemorrhage
Any CNS or pulmonary grade: Permanently stop
Any other place
Grade 2: Delay until issue is rectified; then, restart dose
Grade 3, initial event: Delay resume at same dose until resolved
Grade 3, second event, or grade 4: Permanently stop Pneumonitis
For persistent or recurring pneumonitis in Grade 2, wait until Grade 1 and then think about starting again at the following lower dose
Grade 3 or 4: Discontinue forever Renal impairment
There is no need to alter the dosage for creatinine clearance 30 to 90 ml/min
End-stage renal disease (ESRD) with or without dialysis or creatinine clearance 15–30 ml/min: Unknown pharmacokinetics Hepatic impairment
Mild: Carefully watch for side effects; do not change the beginning dose
Moderate to severe: Do not use Dosing consideration
Ocular examination: Do an eye examination, including slit lamp testing for visual acuity, at baseline, before each dose, and as clinically necessary
Topical corticosteroid eye drops: After examination with a slit lamp, determine the initial prescription and all renewals of any corticosteroid medication
Use topical ocular vasoconstrictor drops to each eye just prior to each infusion
Topical lubricating ophthalmic drops: Inform patients to use them throughout the course of treatment and for 30 days following the last dosage
Contact lenses: For the whole course of treatment, advise patients to refrain from wearing contact lenses unless instructed to do so by their eye doctor
Cervical cancer remains one of the most prevalent gynecologic cancers in the world. According to the most recent data, it ranks 14th among all malignancies and 4th among women globally. The primary and secondary emphasis of cervical cancer intervention is primary and secondary prevention.
Primary prevention and screening are the most effective techniques for reducing cervical cancer incidence and mortality. In the US and other developing nations, the majority of screening and diagnostic efforts focus on early detection of HPV lesions by HPV testing and Pap smears.
Although HPV testing is not advised for women under 30 years of age, the United States Preventive Services Task Force recommends that low-risk younger women begin screening with Pap smears at age 21. Women at risk are recommended to continue these tests until the age of 65.
Based on earlier results and the use of these tests and more recent guidelines suggest screening intervals of 3 to 5 years. Because cervical cancer is caused by a STI, it is avoidable. Education, consistent screenings, and effective interventions can reduce the burden of this disease. Just like other diseases and cancers,
In the United States, African American women have a significantly higher cervical cancer mortality rate. Since 2006, vaccines to help prevent cervical cancer have been accessible. Vaccination can reduce cancer mortality rates in nations with limited resources which don’t have the resources for regular screenings and have higher fatality rates.
More than 500,000 new instances of cervical cancer are diagnosed annually on a global scale. Cervical Cancer claims around 250,000 lives every year. Women in areas with scarce resources, Hispanics, and African American women have lower rates of evidence-based care and a significantly higher death rate than women in other demographic groups. HPV, the virus which causes cervical cancer is an STI.
Mortality rate is much higher in women who have not been screened in the past 5 years for cervical cancer. The lack of regular follow-ups after being diagnosed with a precancerous lesion is another factor that drives up the mortality rate. Ongoing trends suggest that women with highest risk of mortality are perhaps less likely to get vaccinated.
The causal agent of cervical cancer is HPV. Over 75% of cases are significantly related to high-risk HPV 16 and 18. Although more than 500,000 cases of HPV are diagnosed annually, most cases are low-grade infections that cure on their own within two years.
According to current research, Human Papillomavirus (HPV) is present in most sexually active individuals sometime in their lives. There are around 130 recognized kinds of HPV, 20 of which have been linked to cancer.
Cervical dysplasia rates associated with HPV are solely known in women, as men are not examined outside of study protocols. HPV 16 and 18 are the most prevalent types of HPV detected in invasive cervical cancer.
Most cases of high-risk HPV occur in women under the age of 25 — various studies suggest that most cases of HPV do not lead to cancer in women aged above 25. Nevertheless, co-infection may reduce the likelihood of spontaneous clearance and cancer progression.
Some factors which increase the risk for Cervical cancer and contracting HPV are:
Use of oral contraceptives
Herpes Simplex Virus
HIV
Other genital illnesses like chlamydia
More than 1 sexual partner
Smoking
HPV is transmitted through skin-to-skin contact, which includes sexual contact, hand-to-genital organ touch, and oral sex.
Vaccines are around 90% effective against HPV. HPV patients who have been diagnosed late have an exponentially higher possibility of developing cervical cancer than individuals who are screened regularly, so inconsistent screening is a significant risk factor for cervical cancer.
According to the SEER database, 5-year survival rates are determined by the extent of the spread of cancer in the body. If the cancer is localized the survival rate is 92%; if the cancer has spread to lymph nodes near the uterus and cervix it is 58%; and it’s approximately 18% when distant parts of the body and organs near the cervix have been affected by the cancer.
Factors which affect significantly affect outcomes in patients with cervical cancer are:
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