Optimal follow-up of cervical cancer patients

Gynecological malignancies account for round 10 % of all female cancers, with the cervical cancer being one of the major women health problems in developing regions of the world. Surveillance programs of cervical cancer are primarily based on recurrence rates, timing of recurrence, salvage options, and chances for curing patients with recurrence. Since there is no prospective, high evidence data about optimal surveillance program after primary treatment of patients with cervical cancer recommendations are based on the review of retrospective data sets. Literature search on this topic showed that there is no proven survival benefit for any follow-up schedule. Counseling the patients about early possible signs and symptoms of recurrent disease is of great importance. From all the diagnostic tools available, history taking and clinical examination, including comprehensive gynecological examination, still contribute to the greatest number of recurrence detection. Chest radiograph and computed tomography of abdomen and pelvis could be done in high-risk patients taking into account initial stage of the disease, previous treatment, symptom status, and local findings in order to detect potentially salvageable recurrences. Otherwise, radiologic tests are usually employed when a suspicion of recurrence is raised. Follow-up plan should be tailored according to estimated risk of relapse for individual patient.