Cervical Disease and Neoplasia
Although the incidence and mortality from cervical cancer have decreased substantially in the past sev-eral decades among women in the United States, cervical cancer remains the third most common gynecologic cancer. In countries where cytologic screening is not widely available, cervical cancer remains common. Worldwide, it is the second most common cancer among women, the third most common cause of cancer-related death, and the most common cause of mortality from gynaecologic malignancy.
Cervical cancer can be thought of as a “controllable” cancer. It is preceded by an identifiable precursor lesion (cervical intraepithelial neoplasia, CIN) that may (but not always) progress to invasive cancer. CIN can be easily detected by an inexpensive and noninvasive screening test (Pap test) that may be augmented with adjunctive tests such as HPV DNA typing and a follow-up diagnostic procedure (colposcopy). CIN is treatable with simple and effective therapies, including cryotherapy, laser ablation, loop elec-trosurgical excision procedure (LEEP), and cold knife cone biopsy, all of which have high cure rates. It is also one of only a few cancers for which a vaccine exists that may have a significant impact in reducing an individual’s risk.