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2017 | 15 | 1 | 24–33

Article title

Zalecenia Polskiego Towarzystwa Ginekologii Onkologicznej dotyczące diagnostyki i leczenia raka szyjki macicy


Title variants

Recommendations of the Polish Gynecological Oncology Society for the diagnosis andtreatment of cervical cancer

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Cervical cancer (CC) is currently the third most common cancer among women and the fourth leading cause of cancer-related death in women worldwide(1). In Poland in 2013, CC accounted for 3.7% of all newly registered tumor cases among women, and was the sixth most common female malignancy. At the same time, CC is the seventh leading cause of cancer-related death among Polish women(2). Epidemiological indicators differ depending on patient’s age. CC is responsible for 8% of cancer-related cases and 11% of cancer-related deaths among young women (aged between 20 and 44 years). Persistent human papillomavirus (HPV) infection is the most important factor in the development of cervical neoplasm. The incidence of CC is associated with the occurrence of HPV in a given population. In countries with a high incidence of this cancer, persistent HPV infection affects approximately 10–20% of the population, while the same rate is 5–10% in countries with lower incidence. Vaccination against HPV prevents infection with certain types of viruses, and consequently the development of cancer induced by a given type of virus. Other risk factors that increase the probability of disease include smoking tobacco, multiple vaginal deliveries, the use of oral contraceptives by women smokers, early sexual initiation, multiple sexual partners, positive history for sexually transmitted diseases, certain autoimmune diseases and chronic immunosuppression(3).
Rak szyjki macicy (RSM) jest obecnie trzecim nowotworem u kobiet pod względem częstości zachorowań oraz czwartą przyczyną zgonów nowotworowych kobiet na świecie(1). W Polsce w 2013 roku RSM stanowił 3,7% wszystkich nowo zarejestrowanych przypadków nowotworów wśród kobiet, będąc zarazem szó- stym, pod względem zachorowalności, nowotworem złośliwym rozpoznawanym u  kobiet. Jednocześnie RSM stanowi siódmą przyczynę zgonów nowotworowych kobiet w Polsce(2). Wskaźniki epidemiologiczne różnią się w zależ- ności od wieku pacjentek. W populacji młodych kobiet (20.–44. roku życia) RSM odpowiada za 8% zachorowań oraz 11% zgonów nowotworowych.










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  • 1. Ferlay J, Soerjomataram I, Dikshit R et al.: Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359–E386.
  • 2. Didkowska J, Wojciechowska U: Nowotwory złośliwe w Polsce w 2013 roku. Centrum Onkologii – Instytut im. M. Skłodowskiej-Curie, Warszawa 2015.
  • 3. Tjalma WA, Fiander A, Reich O et al.; HERACLES/SCALE Study Group: Differences in human papillomavirus type distribution in high-grade cervical intraepithelial neoplasia and invasive cervical cancer in Europe. Int J Cancer 2013; 132: 854–867.
  • 4. Jach R, Basta A, Kotarski J et al.: Ten years of anti-HPV vaccinations: what do we know? Prz Menopauzalny 2016; 15: 170–175.
  • 5. Saslow D, Solomon D, Lawson HW et al.; American Cancer Society; American Society for Colposcopy and Cervical Pathology; American Society for Clinical Pathology: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol 2012; 137: 516–542.
  • 6. https://guidelines.esgo.org/about/guidelines-in-development/ cervical-cancer.
  • 7. Pecorelli S, Zigliani L, Odicino F: Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet 2009; 105: 107–108.
  • 8. Kalof AN, Dadmanesh F, Longacre TA et al.: Protocol for the Examination of Specimens from Patients with Carcinoma of the Uterine Cervix. College of American Pathologists, 2012. Available from: http://www.cap.org/apps/docs/committees/cancer/ cancer_protocols/2012/Cervix_12protocol.pdf.
  • 9. Delgado G, Bundy B, Zaino R et al.: Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol 1990; 38: 352–357.
  • 10. Querleu D, Morrow CP: Classification of radical hysterectomy. Lancet Oncol 2008; 9: 297–303 oraz Gynecol Oncol 2009; 115: 314–315.
  • 11. Tewari KS, Sill MW, Long HJ 3rd et al.: Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med 2014; 370: 734–743.

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