The Early Diagnosis of Cervical Carcinoma
CARCINOMA of the cervix is the commonest of gynecologic neoplasms and emulates carcinoma of the breast as the malignancy occurring most frequently in women. Because of this frequency, its diagnosis and control is within the province of all physicians, not gynecologists alone. With detection methods now generally available, and our present forms of therapy, it is theoretically possible to eliminate carcinoma of the cervix as a cause of death. Practically, we can improve radically our survival statistics.
The above conclusions are based on common knowledge. There is an inverse ratio between the advancement of malignancy at the time of diagnosis and the rate of survival. With patients in whom malignancy is detected early we can expect a survival rate of almost 100 per cent while survival may be nonexistent in the advanced cases. In all reported statistics, the preponderance of cases is in the moderately and far advanced groups. Thus, if we emphasize the importance of early diagnosis, and institute vigorous therapy when carcinoma is first detected, our survival statistics cannot but improve.
We, as physicians, are responsible in part for the toll in life and disability exacted by carcinoma each year; the patient is also at fault. Miller1 reports a total delay (from onset of symptoms to institution of therapy) of 8.5 months. Doctors are directly responsible for 3 months’ delay, and patients for 5.5 months’ delay. This assumes greater significance when one recalls that there may be no symptoms of an early cervical carcinoma, and that bleeding, the. . .