1.Overview
2. Diagnosis
2.1 Etiology
2.2 Clinical manifestation
2.2.1 Symptoms
2.2.2 Signs
2.3 Auxiliary examination
2.3.1 Cervical/vaginal cytology examination and HPV test
2.3.2 Histological examination
2.3.3 Cervical colposcopy
2.3.4 Cystoscopy and rectoscopy examination
2.3.5 Imaging examination
2.3.6 Tumor markers examination
2.4 Diagnostic criteria for cervical cancer
2.4.1 Clinical diagnosis
2.4.2 Pathological diagnosis
2.5 Differential diagnosis
2.5.1 Benign lesions of cervix
2.5.2 Metastatic carcinoma of cervix
3. Classification and staging of cervical cancer
3.1 Histological classification for cervical cancer
3.2 Staging of cervical cancer
4. Treatment
4.1 Cervical cancer staging and treatment options
4.1.1 Microscopic diagnosis for invasive carcinoma
4.1.2 Invasive cervical carcinoma
4.2 Surgical treatment
4.3 Radiotherapy
4.3.1 Principles of radiotherapy
4.3.2 EBRT
4.3.3 Brachytherapy
4.3.4 Combination of brachytherapy and EBRT
4.3.5 Complications of radiotherapy
4.3.6 Normal tissue considerations
4.4 Chemotherapy
4.4.1 Concurrent chemoradiation
4.4.2 Neoadjuvant chemotherapy
4.4.3 Palliative chemotherapy
5. Follow-up
Cervical cancer is one of the most common gynecological malignancies worldwide. The incidence of cervical cancer ranks second for female malignancies in China. There are about 500,000 new cases of cervical cancer worldwide every year, and more than 80% of them occur in developing countries. About 130,000 new cases occur annually in China, accounting for 28% of the total number of new cases for cervical cancer worldwide. The peak age for diagnosis is 40−60 years old; however, the age of onset is becoming younger in recent years. The incidence of cervical cancer has regional differences, with the incidence in developing countries being higher compared to developed countries. The occurrence of cervical cancer could be effectively controlled by early examination, diagnosis and treatment of precancerous lesions.
This guideline applies to cervical squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma, which account for more than 90% of cervical cancer. Several unique pathological types have low incidences, and no consensus has been reached regarding its diagnosis and treatment in China and abroad. Hence, this guideline is not appropriate for cervical cancer with rare pathological types. This guideline references internationally recognized guidelines for the diagnosis and treatment of cervical cancer and is amended according to our past guidelines. In current clinical practice, more attention is paid for comprehensive and individualized treatment. Current treatment strategies are influenced by a combination of hospital equipment, technigue and patient’s condition. With regards to patients with complex cervical cancer, clinicians should follow these guidelines in a rational manner. For patients that fall out of these guidelines, clinical trials should be recommended.
