Cervical cancer: Epidemiology, risk factors and screening

Shaokai Zhang; Huifang Xu; Luyao Zhang; Youlin Qiao

doi:10.21147/j.issn.1000-9604.2020.06.05

Cervical cancer: Epidemiology, risk factors and screening

Chin J Cancer Res. 2020 Dec 31;32(6):720-728. doi: 10.21147/j.issn.1000-9604.2020.06.05.

Authors

Shaokai Zhang¹, Huifang Xu¹, Luyao Zhang¹, Youlin Qiao^{1

2}

Affiliations

¹ Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou 450008, China.
² Department of Epidemiology, National Cancer Center, Chinese Academy of Medical Sciences, School of Population Medicine and Public Health, Peking Union Medical College, Beijing 100021, China.

PMID: 33446995
PMCID: PMC7797226
DOI: 10.21147/j.issn.1000-9604.2020.06.05

Abstract

Cervical cancer is one of the leading causes of cancer death among females worldwide and its behavior epidemiologically likes a venereal disease of low infectiousness. Early age at first intercourse and multiple sexual partners have been shown to exert strong effects on risk. The wide differences in the incidence among different countries also influenced by the introduction of screening. Although the general picture remains one of decreasing incidence and mortality, there are signs of an increasing cervical cancer risk probably due to changes in sexual behavior. Smoking and human papillomavirus (HPV) 16/18 are currently important issues in a concept of multifactorial, stepwise carcinogenesis at the cervix uteri. Therefore, society-based preventive and control measures, screening activities and HPV vaccination are recommended. Cervical cancer screening methods have evolved from cell morphology observation to molecular testing. High-risk HPV genotyping and liquid-based cytology are common methods which have been widely recommended and used worldwide. In future, accurate, cheap, fast and easy-to-use methods would be more popular. Artificial intelligence also shows to be promising in cervical cancer screening by integrating image recognition with big data technology. Meanwhile, China has achieved numerous breakthroughs in cervical cancer prevention and control which could be a great demonstration for other developing and resource-limited areas. In conclusion, although cervical cancer threatens female health, it could be the first cancer that would be eliminated by human beings with comprehensive preventive and control strategy.

Keywords: Cervical cancer; epidemiology; risk factors; screening.