Tumors of the Cervix

Cervical cancer continues to represent a global epidemic with approximately 500,000 new cases and 250,000 deaths reported annually worldwide. In developed countries, the implementation of screening programs employing serial cervical cytology with and without high-risk human papillomavirus (HPV) testing has reduced both incidence and mortality rates significantly. HPV vaccination is expected to reduce these rates even further, although widespread adoption of Advisory Committee on Immunization Practices recommendations for HPV vaccination for females and males has not yet occurred. However, in the USA, only 12--13,000 new cases are reported each year, indicating that a malignancy that had once been the number one cancer killer of American women in the 1940s, has now become a rare cancer according to National Cancer Institute guidelines of what constitutes a rare tumor. Interestingly, there are myriad histological subtypes of cervical cancer, many with distinct biological behavior and/or characteristic gene expression. This chapter will highlight the pathological and clinical manifestations of many of these uncommon subtypes.