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Female genital organs.

In 1991, 456 new cases of cancer of the cervix uteri were reported to the Swedish Cancer Registry. The incidence of cervical cancer has decreased substantially in Sweden since the mid-1960’s. The age-adjusted incidence rate dropped from 18.2 in 1972 to 9.4 per 100 000 women in 1991 ( I ) . Current evidence indicates that one important cause of cervical cancer is infection of the cervix with the human papilloma virus (HPV). This infection is acquired most commonly through sexual intercourse, thus a possible explanation of the observed associations with number of sexual partners and age at first intercourse (2, 3). There is strong evidence that Papanicolaou smear testing may reduce both incidence and mortality of cervical cancer (4-9). The introduction of the Pap smear tests led to an increased frequency of discovered carcinoma in situ, which in turn led to early treatment and a decrease in incidence of and mortality from cervical cancer (5 . 7. 8). Since the decline in the incidence of cancer of the cervix started before the introduction of screening in Sweden, some effects must be attributed to other factors. e.g.. improvements in the public and professional awareness and more resources available in the health services (10). Current treatment for cancer of the cervix is surgery for early stages and radiotherapy for more advanced stages. Radiotherapy may also be used in combination with surgery in cases with a poor prognosis, e.g., with spread to the lymph nodes or surgically incompletely resected tumors. In patients with advanced or recurrent disease, single-agent chemotherapy constitutes the treatment of choice (9).