Examining the latest in cervical cancer care

Cervical cancer can be prevented by vaccination for the human papilloma virus (HPV) and regular screening, yet it still accounts for the deaths of about 350,000 women worldwide each year. In 2025, the American Cancer Society estimates there will be 13,360 new U.S. cases and 4,320 deaths from the disease. The median age at diagnosis is 50.

UCI Health gynecologic oncologist Dr. Krishnansu S. Tewari recently published a comprehensive analysis of cervical cancer care in the New England Journal of Medicine, detailing advances in treatment options that have improved survival, including chemotherapy, radiotherapy and targeted immunotherapies. He also highlighted developments in better disease management.

Tewari’s timely review explored the results of numerous randomized clinical trials as well as recent approvals of drugs by the U.S. Food and Drug Administration and its European Union counterpart, the European Medicines Agency. He also assessed new cervical cancer treatment guidelines issued by the National Comprehensive Cancer Network.

Some key findings:

• Cervical cancer is preventable through vaccination and treatment of dysplasia identified through cytologic screening, DNA testing for high-risk human papilloma virus subtypes, or both.
• Early-stage cervical cancer is treated with open radical hysterectomy and pelvic lymphadenectomy; small lesions can be treated with extrafascial hysterectomy or more conservative fertility-preserving operations.
• Locally advanced disease is treated with chemoradiation therapy plus brachytherapy; incorporating immunotherapy in stage III through IVa cases is associated with a survival benefit.
• Patients with newly diagnosed recurrent or metastatic disease may benefit from chemotherapy and recently approved immunotherapy treatments, with or without bevacizumab, a targeted therapy that limits the blood supply to cancer tumors.
• Antibody–drug conjugates, which can deliver toxic agents directly into cancer cells, may be an option for patients with disease progression after treatment with chemotherapy and immunotherapy.

But more is needed, according to Tewari, who leads UCI Health Gynecologic Oncology Services and is widely published in gynecologic cancer journals.

To achieve the World Health Organization’s goal of eradicating cervical cancer by 2030 will require a concerted effort among nations.

“The tools exist for global eradication of cervical cancer,” he say. “However, without public health policy prioritization and substantial funding, mass vaccination campaigns and the provision of adequate screening of women worldwide, it will not occur.”

Learn more about UCI Health Gynecologic Oncology Services ›