ABSTRACT
With the impact of screening programmes in reducing the incidence of squamous carcinoma of the cervix it is timely that attention is concentrated on glandular lesions. There is convincing evidence that adenocarcinoma of the cervix is increasing in incidence, and this may be related to either oral contraceptive use, human papillovirus infections, or both. Compared to its squamous cancer counterpart the response to therapy, particularly irradiation, is less than optimal, and it is clear that multicentre randomised trials are urgently required to delineate the optimal management of women with this disease.
It is clear from studies in Canada, Scandinavia, and more recently the United Kingdom, that routine Pap smear screening has not only reduced the incidence of squamous carcinoma of the cervix but indeed in the last 10 to 15 years has halved the mortality rate from this disease. In comparison, however, the incidence rate of adenocarcinoma has at best stabilised and at worst increased by even up to 15% in the last 10 years.
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