Progress in gynecologic cancer detection and treatment

Slow but steady progress has been made in the earlier diagnosis and better treatment of gynecological cancers, particularly over the last 50 years. Ce rvical cytology screening programs, where implemented, have led to a remark able reduction in both the incidence and mortality from clinically invasive cervical cancer. This relatively simple technology has been truly one of t he major success stories of modern medicine, but unfortunately this techniq ue has not been uniformly applied to all women in the world, particularly t o women in developing countries. New research into cervical cancer etiology , the role of HPV, and the development of vaccines against this virus offer a great hope particularly for developing countries. In addition, the combi nation of radiotherapy and chemotherapy has resulted in a marked improvemen t in outcome results for women with advanced cervical cancer. Ovarian cance r has seen the development of effective chemotherapy strategies for this di sease. Currently this disease remains one of the major scourges in industri alized countries but the continued evolution of knowledge with regard to op timum sequencing of chemotherapeutic agents and surgery offers the prospect for better outcomes, less morbidity and a better quality of life. Ongoing research into the development of newer chemotherapeutic agents and a better understanding of the actual mechanisms regarding the efficacy of chemother apy and drug resistance offers great promise for the future. Endoscopic sur gery for staging and also for therapy shows promise for improved quality of life as well as outcomes for patients in the future and offers the challen ge of trying to make this technology readily available to all women in the world. As we gain a better understanding of the molecular basis of disease and health we will truly be able to intervene in a preventive mode in the n ew millennium. (C) 2000 International Federation of Gynecology and Obstetri cs.