Cervical cancer in pregnancy: Diagnostic and therapeutic challenges

Document Type : Review Article

Authors

1 M.Sc. of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Associate Professor, Department of Radiation Oncology, Colorectal Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

3 Assistant Professor, Department of Radiation Oncology, Solid Tumor Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Professor, Department of Obstetrics and Gynecology, Ovulation Disorder Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Cancer is the second most common cause of death in women during reproductive ages; however, the occurrence of cancer during pregnancy is very uncommon. With increasing the rate of pregnancies in advanced ages, the incidence of cancer during pregnancy is also being increased. Cervical cancer is one of the most common cancers presenting during pregnancy. This study was performed aimed to review the most important diagnostic and therapeutic approaches in patients with cervical cancer during pregnancy.
Methods: in this narrative review article, the most recent research, reviews, guideline articles and current evidences were selected and reviewed with the main keywords of pregnancy, cancer, cervical, diagnosis, chemotherapy, radiation and surgery and its equivalents; then, the most important and strongest diagnostic and therapeutic recommendations were provided. 34 articles used in this study consisted of all articles in the PubMed database in the time period of 2000 to 2014.
Results: Approximately 1-3% of all cervical cancers are diagnosed during pregnancy, breast-feeding or one year following delivery. Pregnancy is a good opportunity for early diagnosis of cervical cancer. Maternal and fetal health is the most important diagnostic and therapeutic challenges in pregnancy. Fortunately, due to routine health care service and screening during pregnancy, most cervical cancers are detected in early stage. However, due to concern about fetus safety, there are many limitations and contraindications for using diagnostic and therapeutic methods during pregnancy. Treatment type depends on disease stage, tumor histology and gestational age and should be individually determined in each case.
Conclusion: Cervical cancer in pregnancy can be treated successfully. In general, by considering a balance between the mother health and fetal health as the primary goal, evidence-based therapeutic approaches can be used in these patients. Survival of the mother should not be compromised due to delay in beginning of treatment.

Keywords

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