Editing Cervical cancer (section)

==Prognosis==
===Stage===
The prognosis depends on the stage of the cancer. The prognosis for squamous cell carcinoma and adenocarcinoma of the cervix is the same for each given stage.<ref name="Tewari 2025" /> For intraepithelial cervical neoplasms, the prognosis is good.<ref>{{cite book | vauthors = Mello V, Sundstrom RK | chapter = Cervical Intraepithelial Neoplasia. | title = StatPearls [Internet] | location = Treasure Island (FL) | publisher = StatPearls Publishing | date = January 2022 | pmid = 31335091 | chapter-url = https://www.ncbi.nlm.nih.gov/books/NBK544371/ }}</ref>  With treatment, the five-year [[survival rate]] for FIGO stage 1 (cancer confined to the cervix) cervical cancer is 85%, and the overall (all stages combined) five-year survival rate is about 66%.<ref name="Tewari 2025" /><ref name="ACS Key Stats">{{cite web|url=https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html|title=Survival Rates for Cervical Cancer |access-date=27 February 2022 |date=January 3, 2020|publisher=[[American Cancer Society]] |archive-url = https://web.archive.org/web/20220227182815/https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html|archive-date = 27 February 2022}}</ref> Five-year survival in Stage 2 disease (cancer invading beyond upper two-thirds of uterus) is 65%.<ref name="Tewari 2025" /> Stage 3 disease (in which the lower one-third of vagina, pelvic wall is involved or presence of [[hydronephrosis]], pelvic or [[peri-aortic lymph node]] involvement) is 35%. Stage 4 disease, in which cancer extends beyond the pelvis, or involves the bladder or rectum, has a 5 year survival rate of 7%.<ref name="Tewari 2025" />

About 35% of women with invasive cervical cancer have persistent or recurrent disease after treatment.<ref name=AMN>{{cite web | title=Cervical Cancer | work=Cervical Cancer: Pathology, Symptoms and Signs, Diagnosis, Prognosis and Treatment | url=http://www.health.am/cr/cervical-cancer/ | publisher=Armenian Health Network, Health.am | url-status=live | archive-url=https://web.archive.org/web/20070207232901/http://www.health.am/cr/cervical-cancer/ | archive-date=7 February 2007 }}</ref>

===By country===
There is an ethnic disparity in five-year survival in the United States. Average survival rates of the dominant squamous cell carcinoma are 72% for [[Hispanic and Latino Americans|Hispanic]] and [[Asian Pacific Americans|Asian-Pacific]] women, 68% for [[White people|White women]] and 61% for [[Black people|Black women]].<ref>{{cite journal |last1=Cohen |first1=Camryn M. |last2=Wentzensen |first2=Nicolas |last3=Castle |first3=Philip E. |last4=Schiffman |first4=Mark |last5=Zuna |first5=Rosemary |last6=Arend |first6=Rebecca C. |last7=Clarke |first7=Megan A. |title=Racial and Ethnic Disparities in Cervical Cancer Incidence, Survival, and Mortality by Histologic Subtype |journal=Journal of Clinical Oncology |date=December 1, 2022 |volume=41 |issue=5 |pages=1059–1068 |doi=10.1200/JCO.22.01424 |publisher=ASCO Publications|pmid=36455190 |pmc=9928618 }}</ref>

Regular screening has meant that precancerous changes and early-stage cervical cancers have been detected and treated early. Figures suggest that cervical screening is saving 5,000 lives each year in the UK by preventing cervical cancer.<ref name=chelp>{{cite web | title=Cervical cancer statistics and prognosis | url=http://www.cancerhelp.org.uk/help/default.asp?page=9260 | publisher=Cancer Research UK | access-date=24 March 2007 | archive-url=https://web.archive.org/web/20070520092010/http://www.cancerhelp.org.uk/help/default.asp?page=9260 | archive-date=20 May 2007 }}</ref>
About 1,000 women per year die of cervical cancer in the UK.  All of the [[Nordic countries]] have cervical cancer screening programs in place.<ref name=Nygard2011>{{cite journal | vauthors = Nygård M | title = Screening for cervical cancer: when theory meets reality | journal = BMC Cancer | volume = 11 | page = 240 | date = June 2011 | pmid = 21668947 | pmc = 3146446 | doi = 10.1186/1471-2407-11-240 | doi-access = free }}</ref> The Pap test was integrated into clinical practice in the Nordic countries in the 1960s.<ref name=Nygard2011/>

In Africa, outcomes are often worse as diagnosis is frequently at a later stage of the disease.<ref>{{cite journal | vauthors = Muliira RS, Salas AS, O'Brien B | title = Quality of Life among Female Cancer Survivors in Africa: An Integrative Literature Review | journal = Asia-Pacific Journal of Oncology Nursing | volume = 4 | issue = 1 | pages = 6–17 | date = 2016 | pmid = 28217724 | pmc = 5297234 | doi = 10.4103/2347-5625.199078 | doi-access = free }}</ref> In a scoping review of publicly-available cervical cancer prevention and control plans from African countries, plans tended to emphasize survivorship rather than early HPV diagnosis and prevention.<ref>{{Cite journal| vauthors = Dutta T, Meyerson B, Agley J |date=2018|title=African cervical cancer prevention and control plans: A scoping review|journal=Journal of Cancer Policy|volume=16|pages=73–81|doi=10.1016/j.jcpo.2018.05.002|s2cid=81552501}}</ref>

===Adverse Effects===
Chemotherapy works by attacking cells that rapidly divide. This kills cancer cells, but can also impact normal cells leading to adverse side effects. Common chemotherapy side effects include; hair loss, mouth sores, loss of appetite, diarrhea, nausea and vomiting, premature menopause, infertility, and damage to the blood-forming cells within bone marrow. Most acute side effects are temporary, dissipating when treatment ceases, but some can be long-lasting or permanent. Long-term chemotherapy side effects include changes in the menstrual cycle, neuropathy, and [[nephrotoxicity]].<ref>{{cite web |title=Chemotherapy for Cervical Cancer |url=https://www.cancer.org/cancer/types/cervical-cancer/treating/chemotherapy.html |website=www.cancer.org |publisher=American Cancer Society |access-date=24 October 2024 |date=June 28, 2024}}</ref>

Radiation therapy (RT) adverse effects; for a complete side effect list see {{Main|Radiation therapy#Side effects}}

Curative cervical radiation therapy may affect unintended tissues located within the delivery pathway(s) or adjacent to the target lesion, each tissue with a [[Radiosensitivity|unique sensitivity and response to radiation injury]]. Common acute RT effects involve the gastrointestinal system, e.g., diarrhea and constipation; urinary tract, e.g., frequent urination; and may cause [[cervicitis]]. Common late RT complications include: infertility or [[Primary ovarian insufficiency|premature ovarian failure]]; [[vaginal stenosis#Causes|vaginal stenosis]]; lower motor neuron syndrome; [[telangiectasias]], and subsequent hemorrhage; and [[myelopathy|progressive myelopathy]], which may result in irreversible neurologic deficits ranging from minor sensory symptoms to complete [[paraplegia]].<ref name="Majeed2023">{{cite book |last1=Majeed |first1=Hafsa |last2=Gupta |first2=Vikas |title=Adverse Effects of Radiation Therapy |date=August 14, 2023 |publisher=StatPearls Publishing LLC. |url=https://www.ncbi.nlm.nih.gov/books/NBK563259/ |pmid=33085406 |id=NBK563259 |access-date=24 October 2024}}</ref> Radiotherapy late effects (with occurrence rates) include [[osteonecrosis]] (8-20%), [[Interstitial cystitis|bladder ulceration]] (<3%), [[vaginal stenosis]] (>2.5%)<ref name="LateEffects2023">{{cite journal |last1=Schmitt |first1=Luiza G. |last2=Amarnath |first2=Sudha R. |title=Late Effects of Pelvic Radiation Therapy in the Female Patient: A Comprehensive Review |journal=Applied Radiation Oncology |date=September 1, 2023 |volume=2023 |issue=3 |pages=13–24 |doi=10.37549/ARO-D-23-00016 |url=https://www.appliedradiationoncology.com/articles/late-effects-of-pelvic-radiation-therapy-in-the-female-patient-a-comprehensive-review |access-date=16 October 2024}}</ref> and chronic [[Radiation enteropathy|pelvic radiation disease]] (1-10%), e.g., [[Radiation-induced lumbar plexopathy|irreversible lumbosacral plexopathy]].<ref name="CCR-19-2744">{{cite journal |last1=Huh |first1=Jung Wook |last2=Tanksley |first2=Jarred |last3=Chino |first3=Junzo |last4=Willett |first4=Christopher G. |last5=Dewhirst |first5=Mark W. |title=Long-term Consequences of Pelvic Irradiation: Toxicities, Challenges, and Therapeutic Opportunities with Pharmacologic Mitigators |journal=Clinical Cancer Research |date=July 1, 2020 |volume=26 |issue=13 |pages=3079–3090 |doi=10.1158/1078-0432.CCR-19-2744 |pmid=32098770 |url=https://aacrjournals.org/clincancerres/article/26/13/3079/82622/Long-term-Consequences-of-Pelvic-Irradiation |access-date=24 October 2024 |issn=1078-0432}}</ref>

Pelvic radiation also induces secondary malignancies such as [[leukemia]], [[lymphoma]], [[bladder cancer]], pelvic malignancy, [[colorectal cancer]], bone, and [[soft-tissue sarcoma]] with occurrence rates between 0.2 and 1.0% per year for each.<ref name="Majeed2023" />