The American Society of Clinical Oncology (ASCO) has issued its first clinical practice guidelines on treating invasive cervical cancer, the first of its kind linking recommendations to resource availability.
“Access to cervical cancer care varies between regions of the world, both among and within countries. Lower resource settings tend to have limited or no cervical cancer screening programs. As a result, women often have advanced cervical cancer at diagnosis, which requires treatments that may not be readily available in these areas,” ASCO said in a written statement.
The recommendations, developed by a multidisciplinary panel from the United States, Spain, Mexico, Turkey, Canada, Argentina, Zambia, Uganda, South Korea, China, and India, provide guidance for four resource tiers: basic, limited, enhanced, and maximal. Optimal therapy and palliative care are recommended for each setting and for each stage of cervical cancer.
Concurrent radiotherapy and chemotherapy should be standard in enhanced and maximal settings for women with stage IB to IVA disease. In basic settings where patients cannot be treated with radiation therapy, extrafascial hysterectomy either alone or after neoadjuvant chemotherapy may be an option, the guidelines state. Other key recommendations can be found in the ASCO statement.
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