Abstract

PIP: There are an estimated 500,000 cases of cervical cancer every year worldwide, of which 80% occur in developing countries. The World Health Organization has estimated that every year 7 million new cancer cases occur, at least half of which are in low-income countries. In women breast cancer is the most frequent, followed by cervical cancer. Because of late diagnosis and the lack of treatment in the early phase the prospects of treatment are poor. Cervical cancer is the leading malignancy in northeast Brazil, where its annual incidence is 83 cases per 100,000 women. In India 20-70% of female malignant cancers are cervical cancers vs. only 2.6% of female cancers in Sweden. In Kenya cervical cancer dominates in the 40-49 year age group vs. in the 50-59 year age group in high-income countries. The risk factors are early sexual debut, multiple sexual partners, smoking, and papilloma virus infection. Various studies seem to have confirmed that there is an association between cervical cancer and long-term use of oral contraceptives, although some others have questioned this correlation. In Africa and Nigeria in particular patients do not receive adequate treatment. Whereas in Sweden there are 6 oncological regions with at least 1 treatment center and a total of 14 hospitals with high energy radiation therapy, in Africa, with a population of 500 million, there are only 11 countries where such therapy is available. Cervical cancer has a preinvasive stage of 5-10 years and only 10-20% of the cancer in situ develops into invasive cancer. Population-based screening with a 5-10 year interval directed at the high-risk groups would be the most realistic preventive method. In India both visual inspection and cytology was used in a study showing that visual inspection only identified 60% of women as high risk. The screening of the whole population in the 35-64 year age groups every 10 years could reduce the incidence of invasive cervical cancer by about 55%.