Gynaecological cancer in pregnancy — diagnostic, treatment-timing and delivery framework

A 32-year-old woman at 14 weeks gestation, para 1, is referred after an abnormal cervical screening result and a friable, bleeding lesion on the ectocervix at her booking visit. The biopsy returns moderately differentiated squamous cell carcinoma. She wants this pregnancy. The questions are sharp: how do you stage her, what imaging is safe, when do you operate, when do you give chemotherapy, how do you deliver, and — the question she is really asking — will this cancer, or this treatment, harm her baby? This topic is the framework that answers them.^[1][8]

Overview — the surgical-oncology companion

Gynaecological cancer in pregnancy is a malignant tumour of the cervix, ovary, uterus, vulva or vagina diagnosed between conception and delivery — a surgical-oncology subset of cancer in pregnancy. Gestational trophoblastic disease is excluded; it has its own pathway. This page covers the gynaecological-oncology angle. For the broader obstetric depth — the general framework of cancer in pregnancy, the non-gynaecological malignancies (breast, melanoma, haematological), and the antenatal coordination — cross-link malignancy-in-pregnancy.^[1][4]

The overall incidence of cancer in pregnancy is approximately 1 in 1000 and is rising as maternal age increases. Breast cancer is the commonest cancer diagnosed in pregnancy overall; among gynaecological cancers, cervical cancer is the commonest, followed by ovarian. Endometrial and vulvar cancers in pregnancy are vanishingly rare.^[2][11]

^{[1] [2]}

References12ShowHide

1. [1]Amant F, Berveiller P, Boere IA, et al. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Ann Oncol, 2019.PMID 31435648
2. [2]de Haan J, Verheecke M, Van Calsteren K, et al. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients. Lancet Oncol, 2018.PMID 29395867
3. [3]Amant F, von Minckwitz G, Han SN, et al. Prognosis of women with primary breast cancer diagnosed during pregnancy: results from an international collaborative study. J Clin Oncol, 2013.PMID 23610117
4. [4]Peccatori FA, Azim HA Jr, Orecchia R, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2013.PMID 23813932
5. [5]Korakiti AM, Zografos E, van Gerwen M, et al. Long-Term Neurodevelopmental Outcome of Children after in Utero Exposure to Chemotherapy. Cancers (Basel), 2020.PMID 33287323
6. [6]Vandenbroucke T, Verheecke M, Fumagalli M, et al. Effects of cancer treatment during pregnancy on fetal and child development. Lancet Child Adolesc Health, 2017.PMID 30169185
7. [7]Khazzaka A, Rassy E, Sleiman Z, et al. Systematic review of fetal and placental metastases among pregnant patients with cancer. Cancer Treat Rev, 2022.PMID 35182890
8. [8]LeJeune CL, Van Calsteren K, Amant F A multidisciplinary management approach to cervical cancer during pregnancy. Lancet, 2026.PMID 41720126
9. [9]LeJeune CL, Nougaret S, Massera RT, et al. Abdominal shielding not recommended for diagnostic imaging with ionising radiation during pregnancy. Lancet Oncol, 2025.PMID 41167213
10. [10]Vandecaveye V, Amant F, Lecouvet F, et al. Imaging modalities in pregnant cancer patients. Int J Gynecol Cancer, 2021.PMID 33649009
11. [11]de Haan J, Vandecaveye V, Han SN, et al. Difficulties with diagnosis of malignancies in pregnancy. Best Pract Res Clin Obstet Gynaecol, 2016.PMID 26586541
12. [12]Halaska MJ, Uzan C, Han SN, et al. Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy. Int J Gynecol Cancer, 2019.PMID 30898935