Abstract

Introduction: It is possible to prevent mortality due to cervical cancer by appropriate and timely therapy. But it continues to be a major contributor of cancer related deaths globally because of failure in prevention, early detection and timely, appropriate therapy.
Objectives: Objective was to collect information about persisting challenges in management, prevention, prediction of prognosis of cervical cancer.
Methodology: A Simple review was done by using Up-to-date, ERMED CONSORTIUM, Cochrane Library, Delnet, MedIND to get information from available studies and reviews related to prevention, management, prediction of prognosis in cervical cancer and personal experiences were added.
Results: Usually, management of cervical cancer is as per age, parity, stage of cancer, associated disorders. It may be conservative or aggressive multimodality therapy. However after planned therapy outcome is not always as per expectations. Answers need research. Nearly 20% of women with cervical cancer die within the first year of diagnosis. Research continues about factors which affect outcome and recurrence after surgery, radiotherapy, chemoradiotherapy, and differences in efficacy of surgery, chemotherapy, radiotherapy. Despite significant developments in management, results seem to be far from optimal. Over years there has been no demonstrable reduction in the incidence of cervical cancer and deaths due to cervical cancer. More than 50% of women diagnosed with cervical cancer are younger than 50 years, so the quality of life is becoming a challenge. Sometimes extensive surgeries like complete or anterior or posterior exenteration might give satisfaction to treating surgeon but what matters is survival with quality. It is not possible to predict the prognosis and know the best therapy for recurrent disease. In developing countries lack of awareness about prevention, geographical, economic inaccessibility, poor quality services, lack of support from families are barriers to early diagnosis and also safe therapy. A lot of more research seems to be necessary for the best therapy.
Conclusion: In spite of being almost preventable cancer mortality due to cervical cancer continues to be high. At present, it is mostly not possible to predict prognosis. Appropriate management needs more research and a lot needs to be researched about prognosis too.