Female Lower Genital Tract Cancer Prevention

Main Article Content

Bandit Chumworathayi, MD, PhD, FICS, MRTCOG


Female lower genital tract cancers ranks fourth common among all female cancers. They comprises cervical, vaginal, and vulvar cancers. They also share common carcinogenic causes which are oncogenic human papillomaviruses (HPV) infections. Therefore, similar ways of prevention could be applied to these cancers. Those are primary, secondary, and tertiary preventions. Primary prevention comprises preventing HPV transmission and preventive immunization against HPV. Secondary prevention comprises early detection of precancerous lesions by screening means in combination with treatment of the precancerous lesions detected. Vulvar lesion might be seen by a woman herself, however, health personnel are definitely better in doing that during a routine check-up visit for cervical cancer. Tertiary prevention comprises early diagnosis, staging, and effective treatment to these cancers. Although cervical and vaginal cancers still use clinical staging, radiologic and pathologic data has been integrated since 2018. Vulvar cancer has been surgically staged since 1988, and its staging also has been updated in 2018. By using effective primary and secondary prevention, the incidences of these cancers would be decreased. By using effective tertiary prevention, the persistent (resistant/ refractory) or recurrent rates would be decreased.

Keywords: Female lower genital tract, cervix, vagina, vulva, cancer prevention

Article Details

How to Cite
CHUMWORATHAYI, Bandit. Female Lower Genital Tract Cancer Prevention. Medical Research Archives, [S.l.], v. 8, n. 1, jan. 2020. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2033>. Date accessed: 24 may 2024. doi: https://doi.org/10.18103/mra.v8i1.2033.
Research Articles


1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi:10.3322/caac.21492

2. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189(1):12–19.doi:10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F

3. Alemany L, Saunier M, Tinoco L, Quirós B, Alvarado-Cabrero I, Alejo M, et al. Large contribution of human papillomavirus in vaginal neoplastic lesions: a worldwide study in 597 samples. Eur J Cancer. 2014;50(16):2846–2854. doi:10.1016/j.ejca.2014.07.018

4. de Sanjosé S, Alemany L, Ordi J, Tous S, Alejo M, Bigby SM, et al. Worldwide human papillomavirus genotype attribution in over 2000 cases of intraepithelial and invasive lesions of the vulva. Eur J Cancer. 2013;49(16):3450–3461. doi:10.1016/j.ejca.2013.06.033

5. International Collaboration of Epidemiological Studies of Cervical Cancer. Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies [published correction appears in Int J Cancer. 2007 Jun 1;120(11):2525. Berrington de González, Amy [removed]; Green, Jane [removed]]. Int J Cancer. 2007;120(4):885–891. doi:10.1002/ijc.22357

6. Ekalaksananan T, Malat P, Pientong C, Kongyingyoes B, Chumworathayi B, Kleebkaow P. Local cervical immunity in women with low-grade squamous intraepithelial lesions and immune responses after abrasion. Asian Pac J Cancer Prev. 2014;15(10):4197–4201. doi:10.7314/apjcp.2014.15.10.4197

7. Passmore JA, Morroni C, Shapiro S, Williamson AL, Hoffman M. Papanicolaou smears and cervical inflammatory cytokine responses. J Inflamm (Lond). 2007;4:8. doi:10.1186/1476-9255-4-8

8. Centers for Disease Control and Prevention (CDC). FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP) [published correction appears in MMWR Morb Mortal Wkly Rep. 2010 Sep 17;59(36):1184]. MMWR Morb Mortal Wkly Rep. 2010;59(20):626–629.

9. Centers for Disease Control and Prevention (CDC). Recommendations on the use of quadrivalent human papillomavirus vaccine in males--Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011;60(50):1705–1708.

10. Petrosky E, Bocchini JA Jr, Hariri S, Chesson H, Curtis CR, Saraiya M, et al. Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2015;64(11):300–304.

11. WHO. Comprehensive Cervical Cancer Control: A Guide to Essential Practice. 2nd edition. Geneva: World Health Organization; 2014. Available from: https://www.ncbi.nlm.nih.gov/books/NBK269619/

12. Koliopoulos G, Nyaga VN, Santesso N, Bryant A, Martin-Hirsch PP, Mustafa RA, et al. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst Rev. 2017;8(8):CD008587. Published 2017 Aug 10. doi:10.1002/14651858.CD008587.pub2

13. Mustafa RA, Santesso N, Khatib R, Mustafa AA, Wiercioch W, Kehar R, et al. Systematic reviews and meta-analyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy. Int J Gynaecol Obstet. 2016;132(3):259–265. doi:10.1016/j.ijgo.2015.07.024

14. de Fouw M, Oosting RM, Rutgrink A, Dekkers OM, Peters AAW, Beltman JJ. A systematic review and meta-analysis of thermal coagulation compared with cryotherapy to treat precancerous cervical lesions in low- and middle-income countries. Int J Gynaecol Obstet. 2019;147(1):4–18. doi:10.1002/ijgo.12904

15. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018;143 Suppl 2:22–36. doi:10.1002/ijgo.12611

16. Adams TS, Cuello MA. Cancer of the vagina. Int J Gynaecol Obstet. 2018;143 Suppl 2:14–21. doi:10.1002/ijgo.12610

17. Rogers LJ, Cuello MA. Cancer of the vulva. Int J Gynaecol Obstet. 2018;143 Suppl 2:4–13. doi:10.1002/ijgo.12609

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