Advances in cervical cancer management from North American cooperative group clinical trials.

Despite effective screening methods for detecting pre- malignant diseases of the cervix, cervical cancer remains a leading cause of cancer mortality in women globally. There has been a dramatic decline in the age adjusted death rate from cervical cancer in the United States, where cervical cancer has declined from the leading cause of cancer mortality in women prior to 1940 to a point where it is a relatively uncommon cause of cancer mortality today. Despite these advances in screening and early detection reported in the United States, intraepithelial disease detection rates in many non-industrialized countries remain low because screening programs are generally lacking. As a result most cancers detected in many underdeveloped areas of the world are advanced at diagnosis. Furthermore, in such countries there may be inadequacies in physicians trained in the most effective means of treating cervical cancer, technical support required for the effective delivery of radiation therapy or the administration of chemotherapy, and modern equipment required for optimal treatment with radiation therapy. Thus cure rates for women with cervical cancers in many areas of the world remain low.