Therapies and Diagnostics for Cervical Cancer

  • August 2013
  • -
  • BCC Research
  • -
  • 211 pages

STUDY GOALS AND OBJECTIVES

This report provides an overview of the current and potential global market for cervical cancer, including treatments and screening and testing technologies. The report provides comprehensive information on cervical cancer, highlighting treatment guidelines. It identifies and analyzes the key trends driving the global cervical cancer therapeutics market. The key objective is to present a comprehensive analysis of current cervical cancer–related technologies and the utilization of various therapeutic, prophylactic, screening, and diagnostic modalities. The report’s focus is on cervical disorders, current treatment strategies and drugs, chemotherapy, and other treatment modalities and testing and screening methods. Important trends in the field, research, new developments, and sales forecasts by treatment and screening categories from 2012 through 2018 are provided in this report. Issues and trends addressed in this report are based on information from industry sources, regulatory and health care policies, demographics, and other factors that directly affect the cervical cancer market.

The report also focuses on the treatment usage patterns in the global cervical cancer therapeutics market, the competitive landscape and emerging players, and pipeline products. It also details opportunities for future players.

REASONS FOR DOING THIS STUDY

This study was conducted to provide detailed information regarding prophylactics, screening, testing, and treatment options for cervical disorders and cancer. There is an increasing need for new and innovative technologies. This industry is experiencing tremendous growth. Many diseases discussed in this report are global issues, and a need exists for newer diagnostic and treatment strategies. This study looks at most types of diagnostic and treatment strategies for the clinical management of cervical disorders and related cancers.

This BCC market research report will increase the awareness of current and emerging drugs and technologies for cervical cancers, including prophylactics, therapeutics, chemotherapy, and surgical therapy.

INTENDED AUDIENCE

This report is a detailed study of the global cervical cancer market, with key statistics on and analysis of current drugs and screening and diagnostic technologies, latest trends, market structure, market size, key drug segments, and trends in technology. This study examines the areas of market growth in cervical cancer prevention and treatment strategies from the point of view of manufacturers, product suppliers, health care providers, and consumers of cervical cancer products and services. This study will be of interest largely to the pharmaceutical and biotechnology industries, as well as clinics, hospitals, and research institutes. This report may also prove crucial for investment firms in the concerned sector. This report describes tests and prophylactics currently being used for cervical disorders; cancer diagnosis and prognosis; new developments; spending trends; and revenue prospects for technologies. The report provides market data for 2012 to 2018 and also covers commercial prospects, cervical cancer diagnostic tests, current screening methods in use, and future growth.

SCOPE OF THE STUDY

The scope of this study includes testing, prophylactics vaccines, screening tests and methods, and therapeutics markets for cervical cancers. The report also discusses current technologies, new technologies, cervical cancer incidence, and market projections and market share, along with latest trends and new developments.

METHODOLOGY

Both primary and secondary research methodologies were used in preparing this report. Secondary sources include books, newspapers, trade journals, white papers, industry portals and news, government agencies, trade associations, and paid and free databases. The base year of the report is 2012, with forecast data provided through 2018. Historical, base year, and forecast data are provided for each market segment of this report. The report provides a comprehensive review of cervical cancer, including discussion of incidence and development of the disease, drugs currently being used, and diagnostic technologies. The report also reviews technological developments, product innovations/introductions, and recent strategic industry activity of major players across various product categories. Growth rates, global incidence, and projections have been determined through a compilation of data, including past trends, future trends, demographics, incidence, mortality, products in research and development (R&D), and current product growth. Forecasts and projections were based on market trends, potential users, and mergers and acquisitions.

A comprehensive and exhaustive search of the literature was conducted on cervical cancer and disorders; products; global incidence; and drug developments. Secondary sources included scientific journals and articles, textbooks, press releases, marketing literature, other product/promotional literature, annual reports, security analyst reports, and other publications. A patent search and analysis were also completed. Some informal interviews were also conducted with experts and personnel in this area at biotech and pharmaceutical companies. Other resources included academic institutions and technology and consulting companies.

INFORMATION SOURCES

Many companies within the industry were surveyed to obtain data for this study. Included were manufacturers and end users of products, such as pharmaceutical and biotechnical companies and research institutes. Data were gathered from various industry sources. BCC spoke with officials within the industry and consulted newsletters, company literature, product literature, and a host of technical articles, journals, indexes, and abstracts. Exhaustive investigations of databases using key terminology were completed. In addition, data were compiled from current financial, trade, and government sources.

ABOUT THE AUTHOR

Usha Nagavarapu is an experienced pharmaceutical professional with scientific and business development experience. She has managed preclinical discovery programs involving target identification, including investigational new drug (IND) enabling studies, and assisted out-licensing and portfolio development activities. Her strong focus areas include oncology, dermatology, and cardiovascular diseases. She has extensive experience working with early start-ups to fulfill operational obligations while minimizing overall operational cost and burden.

REPORT HIGHLIGHTS

This report provides:
• An overview of the global market for cervical cancer diagnostics and therapies.
• Analyses of global market trends, with data from 2012, estimates for 2013, and projections of compound annual growth rates (CAGRs) through 2018.
• A breakdown of the markets by prophylactics, screening and diagnostics, surgery, radiation therapy, and drug therapy.
• Discussion of cervical cancer biology.
• Delineation of drugs approved to treat the disease, including chemotherapeutic and immunotherapeutic.
• Evaluation of the patent landscape.
• Comprehensive profiles of key companies.

Table Of Contents

TABLE OF CONTENTS

CHAPTER 1 INTRODUCTION 2

STUDY GOALS AND OBJECTIVES 2
REASONS FOR DOING THIS STUDY 2
INTENDED AUDIENCE 2
SCOPE OF THE STUDY 3
METHODOLOGY 3
INFORMATION SOURCES 4
ABOUT THE AUTHOR 4
RELATED BCC REPORTS 4
BCC ONLINE SERVICES 4
DISCLAIMER 5

CHAPTER 2 SUMMARY 7

SUMMARY 7
SUMMARY TABLE CERVICAL CANCER: GLOBAL MARKET FOR DRUGS AND
DIAGNOSTICS, THROUGH 2018 ($ MILLIONS) 7
SUMMARY FIGURE CERVICAL CANCER: GLOBAL MARKET FOR DRUGS AND
DIAGNOSTICS, 2012-2018 ($ MILLIONS) 8

CHAPTER 3 OVERVIEW 10

TABLE 1 MAIN TYPES OF CANCER AND MORTALITY 10
FIGURE 1 MAIN TYPES OF CANCER AND MORTALITY 10
TABLE 2 CANCER: KEY FACTS 11
TABLE 3 PREVENTION STRATEGIES 11
EARLY DETECTION 12
EARLY DIAGNOSIS 12
SCREENING 12
TABLE 4 CURRENT SCREENING METHODS 12
CANCER TREATMENT 12
TABLE 5 NONCOMMUNICABLE DISEASES ACTION PLAN 13
CERVICAL CANCER 13
TABLE 6 HISTORY 14
CERVICAL CANCER RESEARCH AND TREATMENT 14
SENTINEL LYMPH NODE BIOPSY 14
HUMAN PAPILLOMAVIRUS (HPV) VACCINES 14
TARGETED THERAPY 15
HYPERTHERMIA 15
DRUG TREATMENT OF PRECANCERS 15
SYMPTOMS 16
TABLE 7 CERVICAL CANCER SYMPTOMS 16
TABLE 8 ADVANCED CERVICAL CANCER SYMPTOMS 16
DIAGNOSIS 16
TABLE 9 DIAGNOSIS OF CERVICAL CANCER 17
TABLE 10 RISK FACTORS FOR CERVICAL CANCER 17
TREATMENT 18
TABLE 11 CERVICAL CANCER STAGING 18
PROGNOSIS 19

CHAPTER 4 CERVICAL CANCER: BIOLOGY 21

CERVIX 21
CAUSES 21
HUMAN PAPILLOMAVIRUS 22
TABLE 12 HUMAN PAPILLOMAVIRUS: TYPES 23
SYMPTOMS OF GENITAL WARTS 24
HUMAN PAPILLOMAVIRUS (HPV) INFECTIONS AND TRANSMISSION 24
E6/E7 PROTEINS 26
VACCINES 28
TREATMENT OF GENITAL WARTS 29
CANCER SUBTYPES 29
TABLE 13 HISTOLOGIC SUBTYPES OF INVASIVE CERVICAL CARCINOMA 30
TABLE 14 NON-CARCINOMA MALIGNANCIES THAT CAN RARELY OCCUR IN THE
CERVIX 30
NOVEL BIOMARKERS IN CERVICAL CANCER PREVENTION 30
E6/E7 MESSENGER RNA (MRNA) DETECTION 30
P16INK4A 30
OTHER BIOMARKERS 31
EPIGENETIC MARKERS: DNA METHYLATION 31
VIRAL METHYLATION 31
CHROMOSOMAL ABNORMALITIES 32
MICRORNAS (MIRNAS) 32
BIOMARKERS AND THE FUTURE 33

CHAPTER 5 SCREENING 35

WHY SCREENING IS CRITICAL 35
CERVICAL CANCER SCREENING GUIDELINES 36
VACCINATION 36
CERVICAL CANCER DIAGNOSIS 36
EXAMINATION 37
COMPUTED TOMOGRAPHY 37
BIOPSY 38
PRECANCEROUS LESIONS 38
CLINICAL STAGING 39
TABLE 15 THE MAJOR CATEGORIES OF THE INTERNATIONAL FEDERATION OF
GYNECOLOGY AND OBSTETRICS (FIGO) CLASSIFICATION 39
LYMPH NODE EVALUATION 39
TABLE 16 THE INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS
(FIGO) STAGES 40
Additional Staging 40
LIMITATIONS OF TECHNIQUES 40
CERVICAL CANCER SCREENING 41
TABLE 17 TWO SCREENING TESTS THAT HELP PREVENT CERVICAL CANCER OR
DETECT IT EARLY 41
PAP TEST 41
TABLE 18 TYPES OF SCREENING FOR CERVICAL CANCER 43
TABLE 19 PAP TEST INDICATIONS 43
TABLE 20 BETHESDA SYSTEM 45
Pap Tests: Issues 45
HUMAN PAPILLOMAVIRUS (HPV) TEST 45
Tests and Challenges 46
Procedure and Current Status 46
FDA-APPROVED HUMAN PAPILLOMAVIRUS (HPV) TESTS 47
TABLE 21 FDA-APPROVED HUMAN PAPILLOMAVIRUS (HPV) TESTS 47
Digene Hybrid Capture 2 (HC2) High-Risk HPV DNA Test 47
Cervista HPV HR and Genfind DNA Extraction Kit 48
Cervista HPV 16/18 48
cobas Human Papillomavirus (HPV) Test 48
APTIMA Human Papillomavirus (HPV) Assay 49
DIAGNOSTIC TESTS 49
Colposcopy 49
Cervical Biopsies 50
Colposcopic Biopsy 50
Endocervical Curettage (Endocervical Scraping) 50
Cone Biopsy 50
CYSTOSCOPY, PROCTOSCOPY, AND EXAMINATION UNDER ANESTHESIA 51
IMAGING STUDIES 51
CERVICAL CANCER SCREENING GUIDELINES 52
TABLE 22 CERVICAL CANCER SCREENING 52
CERVICAL CANCER SCREENING 53
Total Hysterectomy and Pap Tests: Issues 53
TABLE 23 THE ACS-ASCCP-ASCP RECOMMENDATIONS: CHANGES FROM THE
PREVIOUS ACS GUIDELINES 54
TYPES OF GYNECOLOGIC TUMOR MARKERS 54
TABLE 24 IMPORTANT GYNECOLOGIC TUMOR MARKERS 55
TABLE 25 OTHER POTENTIAL GYNECOLOGIC TUMOR MARKERS 55
CLINICAL USEFULNESS OF TUMOR MARKERS 56
CONCLUSION 56

CHAPTER 6 THE TREATMENT OF CERVICAL CANCER 58

CLINICAL STAGES AND PROGNOSIS 58
TREATMENT 58
RISK FACTORS 58
SCREENING PROGRAMS 58
CYTOLOGIC TESTS 59
CONVENTIONAL CYTOLOGY 59
CLASSIFICATION SYSTEM 59
TABLE 26 THE BETHESDA SYSTEM 60
CERVICAL CANCER TREATMENT STRATEGIES 61
CERVICAL CANCER OVERVIEW 62
STAGE-BASED THERAPY 62
Stage 0 Cancer 62
Stage IA1 Cancer 62
Stage IA2, IB, or IIA Cancer 62
Stage IIB, III, or IVA Cancer 63
Stage IVB and Recurrent Cancer 63
COMPLICATIONS OF THERAPY 64
Radiation-Related Complications 64
Problems Due to Surgeries 64
THERAPEUTIC STRATEGY 64
TABLE 27 DRUGS APPROVED TO TREAT CERVICAL CANCER 65
Chemotherapy 65
TABLE 28 COMMON CHEMOTHERAPY MEDICINES USED TO TREAT CERVICAL
CANCER 65
Cisplatin 66
Ifosfamide (Ifex) 66
Fluorouracil (Adrucil) 66
Paclitaxel (Taxol) 66
Topotecan (Hycamtin) 66
Docetaxel 66
Gemcitabine 68
Vaccines: Inactivated, Viral 68
Human Papillomavirus Vaccine, Quadrivalent (Gardasil) 69
Human Papillomavirus Vaccine, Bivalent (Cervarix) 69
NEW AND PROMISING THERAPIES 69
DRUGS IN CLINICAL TRIALS 70
Ixabepilone 70
ADXS11-001 70
ISA101 Vaccine 70
Veliparib 70
Carcinoembryonic Antigen (CEA) 71
Olaparib 71

CHAPTER 7 CERVICAL CANCER INCIDENCE 73

CANCER WORLDWIDE-THE GLOBAL PICTURE 73
TABLE 29 POPULATION MEASURES AND CANCER INCIDENCE AND MORTALITY IN
REGIONS OF THE WORLD, ESTIMATES 2008-2010 75
COMMON CANCERS 76
TABLE 30 TOTAL NUMBER AND PERCENTAGES OF ALL CANCER DEATHS,
WORLDWIDE, 2008 77
FUTURE TRENDS 77
TABLE 31 THE PROJECTED PERCENTAGE CHANGE IN EUROPEAN
AGE-STANDARDIZED CANCER INCIDENCE RATES PER 100,000 POPULATION, U.K.,
2007-2030
79
GLOBAL INCIDENCE OF CERVICAL CANCER 79
TABLE 32 POPULATION ATTRIBUTABLE FRACTION (%) 80
TABLE 33 CERVICAL CANCER: GLOBAL INCIDENCE, 2008 81
TABLE 34 GLOBAL CERVICAL CANCER: MORTALITY 2008 AND 2030* 82
RECENT BREAKTHROUGHS 83
TABLE 35 WORLDWIDE PREVALENCE OF HUMAN PAPILLOMAVIRUS (HPV) IN
WOMEN WITH CERVICAL CANCER 83
CERVICAL CANCER THOUGH TIME 84
TABLE 36 CERVICAL CANCER BY CONTINENTS, 2008 ESTIMATES 85
TABLE 37 CERVICAL CANCER WORLD AGE-STANDARDIZED INCIDENCE RATES PER
100,000 POPULATION, FEMALES IN WORLD REGIONS, 2008 ESTIMATES 85
TABLE 38 CERVICAL CANCER INCIDENCE AND MORTALITY WORLDWIDE, 2008
(THOUSANDS) 86
FIGURE 2 CERVICAL CANCER INCIDENCE AND MORTALITY WORLDWIDE, 2008
(THOUSANDS) 86
TABLE 39 WORLDWIDE BURDEN OF CERVICAL CANCER BY AREA, 2008 89
TABLE 40 CHANGING TRENDS IN CANCER-SPECIFIC AGE-ADJUSTED INCIDENCE (%) 90
PREVENTION STRATEGIES 93
CERVICAL CANCER AND THE U.S. 94
TABLE 41 U.S.: ESTIMATED NEW CASES AND DEATHS FROM CERVICAL (UTERINE
CERVIX) CANCER, 2012 AND 2013 94
INCIDENCE AND MORTALITY 94
TABLE 42 U.S.: INCIDENCE RATES BY RACE, 2005-2009 95
U.S. Cervical Cancer Mortality 95
TABLE 43 U.S.: DEATH RATES BY RACE, 2005-2009 95
Survival and Stage 96
TABLE 44 STAGE DISTRIBUTION AND FIVE-YEAR RELATIVE SURVIVAL BY STAGE AT
DIAGNOSIS, ALL RACES, FEMALES, 2002-2008 96
TABLE 45 FIVE-YEAR OBSERVED SURVIVAL RATE 97
European Union 97
TABLE 46 CERVICAL CANCER: EUROPEAN AGE-STANDARDIZED INCIDENCE RATES
PER 100,000 POPULATION AMONG FEMALES, EU27 COUNTRIES, 2008 ESTIMATES 98
FIGURE 3 CERVICAL CANCER: EUROPEAN AGE-STANDARDIZED INCIDENCE RATES
PER 100,000 POPULATION AMONG FEMALES, EU27 COUNTRIES, 2008 ESTIMATES 98
U.K. 100
TABLE 47 NUMBER OF NEW CASES AND CRUDE AND EUROPEAN
AGE-STANDARDIZED (AS) INCIDENCE RATES PER 100,000 POPULATION AMONG
FEMALES IN U.K., 2009
100
TABLE 48 CERVICAL CANCER: AVERAGE NUMBER OF NEW CASES PER YEAR AND
AGE-SPECIFIC INCIDENCE RATES PER 100,000 POPULATION AMONG FEMALES IN
U.K., 2007-2009
101
TABLE 49 CERVICAL CANCER: PERCENTAGE CHANGE IN AGE-SPECIFIC INCIDENCE
RATES PER 100,000 POPULATION AMONG FEMALES IN U.K., 2008-2009 102
TABLE 50 CERVICAL CANCER: ONE-YEAR, FIVE-YEAR, AND 10-YEAR CANCER
PREVALENCE AMONG FEMALES IN U.K., DECEMBER 31, 2006 102
TABLE 51 NUMBER OF NEW CASES IN U.K., 2009 AND 2010 103
TABLE 52 U.K.: THE 10 MOST COMMONLY DIAGNOSED CANCERS IN FEMALES IN
1984, 2007, AND 2030 104
TABLE 53 CERVICAL CANCER: THE PROJECTED PERCENTAGE CHANGE IN
EUROPEAN AGE-STANDARDIZED MORTALITY RATES PER 100,000 POPULATION IN
U.K., 2010 AND 2030
104
TABLE 54 U.K.: THE 10 MOST COMMON CAUSES OF CANCER DEATH IN FEMALES IN
1990, 2010, AND 2030 105
India 106
China 107
Africa 108
TABLE 55 KEY STATISTICS IN AFRICA AND ITS REGIONS, 2008 109
TABLE 56 HUMAN PAPILLOMAVIRUS (HPV) PREVALENCE IN THE GENERAL
POPULATION, 2008 110
TABLE 57 AFRICA: PREVALENCE HPV 16 AND/OR HPV 18 AMONG WOMEN WITH
THE FOLLOWING CHARACTERISTICS 110
TABLE 58 INCIDENCE OF CERVICAL CANCER IN AFRICA BY REGION, 2008 111
TABLE 59 MORTALITY OF CERVICAL CANCER IN AFRICA BY REGION, 2008 111
TABLE 60 AGE-STANDARDIZED INCIDENCE RATES OF CERVICAL CANCER IN AFRICA,
2008 111
TABLE 61 AGE-STANDARDIZED MORTALITY RATES OF CERVICAL CANCER IN
AFRICA, 2008 112
SCREENING AND TREATMENT APPROACHES 112
SAUDI ARABIA 113
NIGERIA 113
KENYA 114
GAMBIA 116
CANADA 116
GERMANY 116
TABLE 62 INCIDENCE OF CERVICAL CANCER IN GERMANY, WESTERN EUROPE, AND
THE WORLD, 2008 (RATES PER 100,000 WOMEN PER YEAR) 117
TABLE 63 KEY STATISTICS ON GERMANY, 2010-2025 117
AUSTRALIA 117
TABLE 64 AUSTRALIA: PROJECTED COMMON CANCERS IN FEMALES, 2020 118
TABLE 65 AUSTRALIA: PROJECTED NUMBER OF NEW CERVICAL CANCER CASES
AND AGE-STANDARDIZED RATES AMONG FEMALES WITH 95% PREDICTION
INTERVALS, 2011-2020
119
TABLE 66 AUSTRALIA: PROJECTED CERVICAL CANCER STATISTICS, 2020 119
HONG KONG 119
CONCLUSION 120

CHAPTER 8 CERVICAL CANCER DIAGNOSTICS MARKET 123

TABLE 67 WOMEN UNDERGOING CERVICAL CANCER SCREENING 123
CERVICAL CANCER SCREENING 123
CERVICAL CANCER TESTING GUIDELINES 124
CERVICAL CANCER DIAGNOSTIC TESTS MARKET 125
TABLE 68 WORLDWIDE CERVICAL CANCER DIAGNOSTIC MARKET, THROUGH 2018
($ MILLIONS) 125
FIGURE 4 WORLDWIDE CERVICAL CANCER DIAGNOSTIC MARKET, 2012-2018 ($
MILLIONS) 125
MARKET DRIVERS 126
TABLE 69 MARKET DRIVERS 126
TABLE 70 KEY PLAYERS 127
RESTRAINTS 127
Lack of Appropriate Health Care Infrastructure in Underdeveloped
and Developing Countries 128
HPV VACCINATION 129
Available Vaccines 129
WHO Recommends the Vaccine for Girls Between the Ages of 10
and 13 130
WHO Does Not Recommend the Vaccine for Boys 130
CERVICAL CANCER DIAGNOSTIC TESTS MARKET BY TEST TYPES 131
Pap Smear Test 131
TABLE 71 GLOBAL CERVICAL CANCER DIAGNOSTIC TESTS: PAP SMEAR TESTS
MARKET AND FORECAST, THROUGH 2018 ($ MILLIONS) 131
FIGURE 5 GLOBAL CERVICAL CANCER DIAGNOSTIC TESTS: PAP SMEAR TESTS
MARKET AND FORECAST, 2012-2018 ($ MILLIONS) 131
TABLE 72 NUMBER OF PAP SMEAR TESTS PERFORMED IN THE U.S. AND EUROPE,
2012 AND 2013 (MILLIONS) 133
Pap Tests: U.S. 133
TABLE 73 U.S.: PERCENT OF PAP SMEAR TESTS PERFORMED, 2008 AND 2010 (%) 133
TABLE 74 U.S.: PERCENT OF WOMEN WHO RECEIVE PAP SMEAR TESTS,
AGE-STRATIFIED, 2008 AND 2010 (%) 134
TABLE 75 PAP TESTS ORDERED OR PROVIDED IN U.S., 2010 134
TABLE 76 PAP TESTS ORDERED OR PROVIDED AT OUTPATIENT DEPARTMENT
VISITS IN U.S., 2010 135
Latest Technology 135
Canadian Market 136
Ontario Guidelines 136
Cervical Cancer and India 136
PAP TESTS: BENEFIT OR NOT? 137
TABLE 77 ABNORMALITIES OF THE CERVIX 138
GLOBAL COLPOSCOPY TESTS MARKET 138
TABLE 78 WORLDWIDE ESTIMATED NUMBER OF COLPOSCOPY PROCEDURE TESTS
PERFORMED, 2012-2018 (MILLIONS) 139
FIGURE 6 WORLDWIDE ESTIMATED NUMBER OF COLPOSCOPY PROCEDURE TESTS
PERFORMED, 2012-2018 (MILLIONS) 139
TABLE 79 CERVICAL CANCER COLPOSCOPY: GLOBAL MARKET AND FORECAST,
THROUGH 2018 ($ MILLIONS) 140
FIGURE 7 CERVICAL CANCER COLPOSCOPY: GLOBAL MARKET AND FORECAST,
2012-2018 ($ MILLIONS) 140
TABLE 80 CERVICAL CANCER: COLPOSCOPY TESTS MARKET AND FORECAST IN
U.S., THROUGH 2018 ($ MILLIONS) 140
FIGURE 8 CERVICAL CANCER: COLPOSCOPY TESTS MARKET AND FORECAST IN
U.S., 2012-2018 ($ MILLIONS) 141
Biopsy 142
Types of Cervical Biopsies 142
TABLE 81 TYPES OF CERVICAL BIOPSIES 142
ENDOCERVICAL CURETTAGE (ECC) PROCEDURE MARKET 143
TABLE 82 WORLDWIDE ENDOCERVICAL CURETTAGE (ECC) PROCEDURE MARKET:
SALES AND FORECAST, THROUGH 2018 ($ MILLIONS) 144
FIGURE 9 WORLDWIDE ENDOCERVICAL CURETTAGE (ECC) PROCEDURE MARKET:
SALES AND FORECAST, 2012-2018 ($ MILLIONS) 144
Femasys 144
Liquid-Based Cytology 145
HPV TESTING 145
TABLE 83 WORLDWIDE HUMAN PAPILLOMAVIRUS (HPV) TESTING MARKET: SALES
AND FORECAST, THROUGH 2018 ($ MILLIONS) 146
FIGURE 10 WORLDWIDE HUMAN PAPILLOMAVIRUS (HPV) TESTING MARKET: SALES
AND FORECAST, 2012-2018 ($ MILLIONS) 146
TABLE 84 KEY PLAYERS 147
CURRENT MOLECULAR DIAGNOSTIC TESTS FOR HUMAN PAPILLOMAVIRUS
(HPV) 148
A NEW APPROACH: MESSENGER RNA (MRNA)-BASED DETECTION OF E6/E7
ONCOPROTEINS 148
bioMerieux's Test 148
Roche 149
Innovative Cervical Screening Application Launches in the U.K., and
Ireland 150
Quest Diagnostics 150
OncoHealth 151
QIAGEN/Digene 152
Trovagene 152
Becton, Dickinson and Co.: Human Papillomavirus (HPV) Testing and
Issues 152
NEW DEVICES 153
Zilico 153
LUMA Cervical Imaging System 154

CHAPTER 9 CERVICAL CANCER PROPHYLACTICS MARKET 156

CERVICAL CANCER VACCINES 156
TABLE 85 VACCINES FOR PREVENTION OF CERVICAL CANCER 156
COMPETITION 156
CERVICAL CANCER PROPHYLACTICS MARKET 157
Preventative Vaccines 157
TABLE 86 GLOBAL CERVICAL CANCER PROPHYLACTICS MARKET: SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 157
FIGURE 11 GLOBAL CERVICAL CANCER PROPHYLACTICS MARKET: SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 157
Vaccine Market: Leaders 158
TABLE 87 KEY COMPANIES: CERVICAL VACCINE MARKET REVENUES AND
FORECAST, 2011 AND 2018 ($ MILLIONS) 158
GLOBAL CANCER VACCINES MARKET 159
TABLE 88 GLOBAL VACCINE MARKET: SALES AND FORECAST, THROUGH 2018 ($
MILLIONS) 159
TABLE 89 KEY COMPANIES 159
CANCER VACCINE MARKET: U.S. 160
TABLE 90 U.S. VACCINE MARKET: SALES AND FORECAST, THROUGH 2018 ($
MILLIONS) 160
PROPHYLACTIC VACCINES 160
PROPHYLACTIC CANCER VACCINES MARKET 160
Cervarix 161
TABLE 91 GLOBAL CERVARIX SALES AND FORECAST, THROUGH 2018 ($ MILLIONS) 161
FIGURE 12 GLOBAL CERVARIX SALES AND FORECAST, 2012-2018 ($ MILLIONS) 162
Gardasil 162
TABLE 92 GARDASIL SALES AND FORECAST, 2012 AND 2013 ($ MILLIONS) 163
FIGURE 13 GARDASIL SALES AND FORECAST, 2012 AND 2013 ($ MILLIONS) 163
NEW PRODUCTS 164
VS03 164
TABLE 93 V503 SALES AND FORECAST, 2013 AND 2018 ($ MILLIONS) 164
LATEST DEVELOPMENTS 164
U.K. to Drop Cervarix 164
Cancer Vaccines in Poor Nations 164
CONCLUSIONS 165

CHAPTER 10 THERAPEUTIC MARKET 168

TABLE 94 CERVICAL CANCER THERAPEUTIC MARKET: GLOBAL REVENUE AND
FORECASTS, THROUGH 2018 ($ MILLIONS) 168
FIGURE 14 CERVICAL CANCER THERAPEUTIC MARKET: GLOBAL REVENUE AND
FORECASTS, 2012-2018 ($ MILLIONS) 168
TREATMENT OF CERVICAL CANCER 169
TABLE 95 TYPES OF SURGERY FOR EARLY CERVICAL CANCER 169
CHEMOTHERAPY MARKET 170
CANCER TREATMENT MARKET 170
CANCER THERAPY 171
TABLE 96 MAJOR PLAYERS 172
Cancer Costs in the U.S. 172
TABLE 97 KEY FACTS: CANCER IN U.S., 2020 172
TABLE 98 U.S.: CERVICAL CANCER PREVALENCE ESTIMATES FOR 2010 AND 2020
(THOUSANDS) 173
TABLE 99 CERVICAL CANCER: CANCER PREVALENCE IN U.S. 173
TABLE 100 CANCER CARE COST IN U.S., 2010 AND 2020 ($ BILLIONS) 174
CYTOTOXIC THERAPIES MARKET 174
TABLE 101 CYTOTOXIC THERAPIES MARKET INDICATIONS 175
TABLE 102 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 175
FIGURE 15 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 176
TABLE 103 U.S. CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 176
FIGURE 16 U.S. CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 176
TABLE 104 EUROPEAN CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 177
FIGURE 17 EUROPEAN CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 178
TABLE 105 JAPANESE CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 178
FIGURE 18 JAPANESE CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 179
CERVICAL CHEMOTHERAPY MARKET 179
TABLE 106 CERVICAL CANCER CHEMOTHERAPY MARKET: GLOBAL REVENUE AND
FORECASTS, THROUGH 2018 ($ MILLIONS) 179
FIGURE 19 CERVICAL CANCER MARKET: GLOBAL REVENUE AND FORECASTS,
2012-2018 ($ MILLIONS) 179
TABLE 107 CERVICAL CANCER CHEMOTHERAPY MARKET IN U.S.: SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 180
FIGURE 20 CERVICAL CANCER CHEMOTHERAPY MARKET IN U.S.: SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 181
CHEMOTHERAPY AND DRAWBACKS 181
DRUGS USED IN CHEMOTHERAPY 181
TABLE 108 DRUGS APPROVED TO TREAT CERVICAL CANCER 181
Paclitaxel 181
TABLE 109 SALES OF KEY DRUGS FOR CERVICAL CANCER, 2010 ($ MILLIONS) 182
Carboplatin 182
TABLE 110 CARBOPLATIN SALES, 2010-2012 ($ MILLIONS) 182
Taxotere/Docetaxel 182
TABLE 111 TAXOTERE GLOBAL SALES AND FORECAST, 2010-2012 ($ MILLIONS) 183
Gemzar 183
TABLE 112 GEMZAR REVENUE, 2010 AND 2011 ($ MILLIONS) 184
Future for Gemcitabine as a Drug 184
Cisplatin 185
Hycamtin 185
TABLE 113 HYCAMTIN SALES, 2010-2012 ($ MILLIONS) 186
Bleomycin 186
OTHER TREATMENT DRUGS 186
Avastin 186
TABLE 114 AVASTIN SALES AND FORECAST, THROUGH 2018 ($ MILLIONS) 187
CANCER IMMUNOTHERAPY 188
TREATMENT STRATEGIES 189
TABLE 115 CERVICAL CANCER: TREATMENT OPTIONS, 1999-2008 (%) 189
TREATMENT PROCEDURE COST ESTIMATES 190
CERVICAL CANCER SURGERY 191
TABLE 116 CERVICAL CANCER SURGERY MARKET IN U.S.: SALES AND FORECAST,
THROUGH 2018 ($ MILLIONS) 191
FIGURE 21 CERVICAL CANCER SURGERY MARKET IN U.S.: SALES AND FORECAST,
2012-2018 ($ MILLIONS) 192
COSTS OF CERVICAL CANCER SURGERY 192
TABLE 117 SURGERY/HYSTERECTOMY FOR CERVICAL CANCER: GLOBAL SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 193
FIGURE 22 SURGERY/HYSTERECTOMY FOR CERVICAL CANCER: GLOBAL SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 193
TABLE 118 HYSTERECTOMY FOR CERVICAL CANCER IN U.S.: SALES AND FORECAST,
THROUGH 2018 ($ MILLIONS) 194
FIGURE 23 HYSTERECTOMY FOR CERVICAL CANCER IN U.S.: SALES AND FORECAST,
2012-2018 ($ MILLIONS) 194
RADIATION THERAPY FOR CERVICAL CANCER 195
Radiation Therapy and Cost Estimates 195
TABLE 119 CERVICAL CANCER RADIATION THERAPY MARKET: GLOBAL SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 196
FIGURE 24 CERVICAL CANCER RADIATION THERAPY MARKET: GLOBAL-SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 196
TABLE 120 CERVICAL CANCER RADIATION THERAPY MARKET IN U.S.: SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 197
FIGURE 25 CERVICAL CANCER RADIATION THERAPY MARKET IN U.S.: SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 197
CONCLUSIONS 197
TABLE 121 KEY FACTS ABOUT CERVICAL CANCER 198

CHAPTER 11 PATENT LANDSCAPE 201

TABLE 122 CERVICAL CANCER VACCINE PATENTS (%) 201
GLOBAL IMPACT OF PATENT EXPIRIES 201
PATENT LANDSCAPE 202
Hycamtin (Topotecan Hydrochloride) 203
Gemzar 203
TABLE 123 CERVICAL CANCER CHEMOTHERAPY DRUGS: PATENT EXPIRY 203
Doxil 204
Cisplatin 204
Avastin 204

CHAPTER 12 SELECTED COMPANY PROFILES 206

ABBOTT LABORATORIES 206
ADVAXIS 206
ASTRAZENECA 206
BECTON, DICKENSON AND CO. 207
BRISTOL-MYERS SQUIBB 207
DIGENE CORP. 207
DENDREON CORP. 208
FEMASYS 208
GLAXOSMITHKLINE 208
HOLOGIC 208
ISA PHARMACEUTICALS 209
JOHNSON and JOHNSON 209
MERCK 210
ONCOHEALTH CORP. 210
PFIZER 210
QUEST DIAGNOSTICS 211
QIAGEN 212
ROCHE DIAGNOSTICS 212
SANOFI 212
TAJ PHARMACEUTICALS 213
TEVA PHARMACEUTICAL INDUSTRIES 213
TROVAGENE 213
ZILICO LTD. 214

CHAPTER 13 REFERENCES 216



LIST OF TABLES

SUMMARY TABLE CERVICAL CANCER: GLOBAL MARKET FOR DRUGS AND
DIAGNOSTICS, THROUGH 2018 ($ MILLIONS) 7
TABLE 1 MAIN TYPES OF CANCER AND MORTALITY 10
TABLE 2 CANCER: KEY FACTS 11
TABLE 3 PREVENTION STRATEGIES 11
TABLE 4 CURRENT SCREENING METHODS 12
TABLE 5 NONCOMMUNICABLE DISEASES ACTION PLAN 13
TABLE 6 HISTORY 14
TABLE 7 CERVICAL CANCER SYMPTOMS 16
TABLE 8 ADVANCED CERVICAL CANCER SYMPTOMS 16
TABLE 9 DIAGNOSIS OF CERVICAL CANCER 17
TABLE 10 RISK FACTORS FOR CERVICAL CANCER 17
TABLE 11 CERVICAL CANCER STAGING 18
TABLE 12 HUMAN PAPILLOMAVIRUS: TYPES 23
TABLE 13 HISTOLOGIC SUBTYPES OF INVASIVE CERVICAL CARCINOMA 30
TABLE 14 NON-CARCINOMA MALIGNANCIES THAT CAN RARELY OCCUR IN THE
CERVIX 30
TABLE 15 THE MAJOR CATEGORIES OF THE INTERNATIONAL FEDERATION OF
GYNECOLOGY AND OBSTETRICS (FIGO) CLASSIFICATION 39
TABLE 16 THE INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS
(FIGO) STAGES 40
TABLE 17 TWO SCREENING TESTS THAT HELP PREVENT CERVICAL CANCER OR
DETECT IT EARLY 41
TABLE 18 TYPES OF SCREENING FOR CERVICAL CANCER 43
TABLE 19 PAP TEST INDICATIONS 43
TABLE 20 BETHESDA SYSTEM 45
TABLE 21 FDA-APPROVED HUMAN PAPILLOMAVIRUS (HPV) TESTS 47
TABLE 22 CERVICAL CANCER SCREENING 52
TABLE 23 THE ACS-ASCCP-ASCP RECOMMENDATIONS: CHANGES FROM THE
PREVIOUS ACS GUIDELINES 54
TABLE 24 IMPORTANT GYNECOLOGIC TUMOR MARKERS 55
TABLE 25 OTHER POTENTIAL GYNECOLOGIC TUMOR MARKERS 55
TABLE 26 THE BETHESDA SYSTEM 60
TABLE 27 DRUGS APPROVED TO TREAT CERVICAL CANCER 65
TABLE 28 COMMON CHEMOTHERAPY MEDICINES USED TO TREAT CERVICAL CANCER 65
TABLE 29 POPULATION MEASURES AND CANCER INCIDENCE AND MORTALITY IN
REGIONS OF THE WORLD, ESTIMATES 2008-2010 75
TABLE 30 TOTAL NUMBER AND PERCENTAGES OF ALL CANCER DEATHS,
WORLDWIDE, 2008 77
TABLE 31 THE PROJECTED PERCENTAGE CHANGE IN EUROPEAN
AGE-STANDARDIZED CANCER INCIDENCE RATES PER 100,000 POPULATION, U.K.,
2007-2030
79
TABLE 32 POPULATION ATTRIBUTABLE FRACTION (%) 80
TABLE 33 CERVICAL CANCER: GLOBAL INCIDENCE, 2008 81
TABLE 34 GLOBAL CERVICAL CANCER: MORTALITY 2008 AND 2030* 82
TABLE 35 WORLDWIDE PREVALENCE OF HUMAN PAPILLOMAVIRUS (HPV) IN WOMEN
WITH CERVICAL CANCER 83
TABLE 36 CERVICAL CANCER BY CONTINENTS, 2008 ESTIMATES 85
TABLE 37 CERVICAL CANCER WORLD AGE-STANDARDIZED INCIDENCE RATES PER
100,000 POPULATION, FEMALES IN WORLD REGIONS, 2008 ESTIMATES 85
TABLE 38 CERVICAL CANCER INCIDENCE AND MORTALITY WORLDWIDE, 2008
(THOUSANDS) 86
TABLE 39 WORLDWIDE BURDEN OF CERVICAL CANCER BY AREA, 2008 89
TABLE 40 CHANGING TRENDS IN CANCER-SPECIFIC AGE-ADJUSTED INCIDENCE (%) 90
TABLE 41 U.S.: ESTIMATED NEW CASES AND DEATHS FROM CERVICAL (UTERINE
CERVIX) CANCER, 2012 AND 2013 94
TABLE 42 U.S.: INCIDENCE RATES BY RACE, 2005-2009 95
TABLE 43 U.S.: DEATH RATES BY RACE, 2005-2009 95
TABLE 44 STAGE DISTRIBUTION AND FIVE-YEAR RELATIVE SURVIVAL BY STAGE AT
DIAGNOSIS, ALL RACES, FEMALES, 2002-2008 96
TABLE 45 FIVE-YEAR OBSERVED SURVIVAL RATE 97
TABLE 46 CERVICAL CANCER: EUROPEAN AGE-STANDARDIZED INCIDENCE RATES
PER 100,000 POPULATION AMONG FEMALES, EU27 COUNTRIES, 2008 ESTIMATES 98
TABLE 47 NUMBER OF NEW CASES AND CRUDE AND EUROPEAN
AGE-STANDARDIZED (AS) INCIDENCE RATES PER 100,000 POPULATION AMONG
FEMALES IN U.K., 2009
100
TABLE 48 CERVICAL CANCER: AVERAGE NUMBER OF NEW CASES PER YEAR AND
AGE-SPECIFIC INCIDENCE RATES PER 100,000 POPULATION AMONG FEMALES IN
U.K., 2007-2009
101
TABLE 49 CERVICAL CANCER: PERCENTAGE CHANGE IN AGE-SPECIFIC INCIDENCE
RATES PER 100,000 POPULATION AMONG FEMALES IN U.K., 2008-2009 102
TABLE 50 CERVICAL CANCER: ONE-YEAR, FIVE-YEAR, AND 10-YEAR CANCER
PREVALENCE AMONG FEMALES IN U.K., DECEMBER 31, 2006 102
TABLE 51 NUMBER OF NEW CASES IN U.K., 2009 AND 2010 103
TABLE 52 U.K.: THE 10 MOST COMMONLY DIAGNOSED CANCERS IN FEMALES IN
1984, 2007, AND 2030 104
TABLE 53 CERVICAL CANCER: THE PROJECTED PERCENTAGE CHANGE IN EUROPEAN
AGE-STANDARDIZED MORTALITY RATES PER 100,000 POPULATION IN U.K., 2010
AND 2030
104
TABLE 54 U.K.: THE 10 MOST COMMON CAUSES OF CANCER DEATH IN FEMALES IN
1990, 2010, AND 2030 105
TABLE 55 KEY STATISTICS IN AFRICA AND ITS REGIONS, 2008 109
TABLE 56 HUMAN PAPILLOMAVIRUS (HPV) PREVALENCE IN THE GENERAL
POPULATION, 2008 110
TABLE 57 AFRICA: PREVALENCE HPV 16 AND/OR HPV 18 AMONG WOMEN WITH THE
FOLLOWING CHARACTERISTICS 110
TABLE 58 INCIDENCE OF CERVICAL CANCER IN AFRICA BY REGION, 2008 111
TABLE 59 MORTALITY OF CERVICAL CANCER IN AFRICA BY REGION, 2008 111
TABLE 60 AGE-STANDARDIZED INCIDENCE RATES OF CERVICAL CANCER IN AFRICA,
2008 111
TABLE 61 AGE-STANDARDIZED MORTALITY RATES OF CERVICAL CANCER IN AFRICA,
2008 112
TABLE 62 INCIDENCE OF CERVICAL CANCER IN GERMANY, WESTERN EUROPE, AND
THE WORLD, 2008 (RATES PER 100,000 WOMEN PER YEAR) 117
TABLE 63 KEY STATISTICS ON GERMANY, 2010-2025 117
TABLE 64 AUSTRALIA: PROJECTED COMMON CANCERS IN FEMALES, 2020 118
TABLE 65 AUSTRALIA: PROJECTED NUMBER OF NEW CERVICAL CANCER CASES AND
AGE-STANDARDIZED RATES AMONG FEMALES WITH 95% PREDICTION INTERVALS,
2011-2020
119
TABLE 66 AUSTRALIA: PROJECTED CERVICAL CANCER STATISTICS, 2020 119
TABLE 67 WOMEN UNDERGOING CERVICAL CANCER SCREENING 123
TABLE 68 WORLDWIDE CERVICAL CANCER DIAGNOSTIC MARKET, THROUGH 2018 ($
MILLIONS) 125
TABLE 69 MARKET DRIVERS 126
TABLE 70 KEY PLAYERS 127
TABLE 71 GLOBAL CERVICAL CANCER DIAGNOSTIC TESTS: PAP SMEAR TESTS
MARKET AND FORECAST, THROUGH 2018 ($ MILLIONS) 131
TABLE 72 NUMBER OF PAP SMEAR TESTS PERFORMED IN THE U.S. AND EUROPE,
2012 AND 2013 (MILLIONS) 133
TABLE 73 U.S.: PERCENT OF PAP SMEAR TESTS PERFORMED, 2008 AND 2010 (%) 133
TABLE 74 U.S.: PERCENT OF WOMEN WHO RECEIVE PAP SMEAR TESTS,
AGE-STRATIFIED, 2008 AND 2010 (%) 134
TABLE 75 PAP TESTS ORDERED OR PROVIDED IN U.S., 2010 134
TABLE 76 PAP TESTS ORDERED OR PROVIDED AT OUTPATIENT DEPARTMENT VISITS
IN U.S., 2010 135
TABLE 77 ABNORMALITIES OF THE CERVIX 138
TABLE 78 WORLDWIDE ESTIMATED NUMBER OF COLPOSCOPY PROCEDURE TESTS
PERFORMED, 2012-2018 (MILLIONS) 139
TABLE 79 CERVICAL CANCER COLPOSCOPY: GLOBAL MARKET AND FORECAST,
THROUGH 2018 ($ MILLIONS) 140
TABLE 80 CERVICAL CANCER: COLPOSCOPY TESTS MARKET AND FORECAST IN U.S.,
THROUGH 2018 ($ MILLIONS) 140
TABLE 81 TYPES OF CERVICAL BIOPSIES 142
TABLE 82 WORLDWIDE ENDOCERVICAL CURETTAGE (ECC) PROCEDURE MARKET:
SALES AND FORECAST, THROUGH 2018 ($ MILLIONS) 144
TABLE 83 WORLDWIDE HUMAN PAPILLOMAVIRUS (HPV) TESTING MARKET: SALES
AND FORECAST, THROUGH 2018 ($ MILLIONS) 146
TABLE 84 KEY PLAYERS 147
TABLE 85 VACCINES FOR PREVENTION OF CERVICAL CANCER 156
TABLE 86 GLOBAL CERVICAL CANCER PROPHYLACTICS MARKET: SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 157
TABLE 87 KEY COMPANIES: CERVICAL VACCINE MARKET REVENUES AND FORECAST,
2011 AND 2018 ($ MILLIONS) 158
TABLE 88 GLOBAL VACCINE MARKET: SALES AND FORECAST, THROUGH 2018 ($
MILLIONS) 159
TABLE 89 KEY COMPANIES 159
TABLE 90 U.S. VACCINE MARKET: SALES AND FORECAST, THROUGH 2018 ($
MILLIONS) 160
TABLE 91 GLOBAL CERVARIX SALES AND FORECAST, THROUGH 2018 ($ MILLIONS) 161
TABLE 92 GARDASIL SALES AND FORECAST, 2012 AND 2013 ($ MILLIONS) 163
TABLE 93 V503 SALES AND FORECAST, 2013 AND 2018 ($ MILLIONS) 164
TABLE 94 CERVICAL CANCER THERAPEUTIC MARKET: GLOBAL REVENUE AND
FORECASTS, THROUGH 2018 ($ MILLIONS) 168
TABLE 95 TYPES OF SURGERY FOR EARLY CERVICAL CANCER 169
TABLE 96 MAJOR PLAYERS 172
TABLE 97 KEY FACTS: CANCER IN U.S., 2020 172
TABLE 98 U.S.: CERVICAL CANCER PREVALENCE ESTIMATES FOR 2010 AND 2020
(THOUSANDS) 173
TABLE 99 CERVICAL CANCER: CANCER PREVALENCE IN U.S. 173
TABLE 100 CANCER CARE COST IN U.S., 2010 AND 2020 ($ BILLIONS) 174
TABLE 101 CYTOTOXIC THERAPIES MARKET INDICATIONS 175
TABLE 102 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 175
TABLE 103 U.S. CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 176
TABLE 104 EUROPEAN CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 177
TABLE 105 JAPANESE CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 178
TABLE 106 CERVICAL CANCER CHEMOTHERAPY MARKET: GLOBAL REVENUE AND
FORECASTS, THROUGH 2018 ($ MILLIONS) 179
TABLE 107 CERVICAL CANCER CHEMOTHERAPY MARKET IN U.S.: SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 180
TABLE 108 DRUGS APPROVED TO TREAT CERVICAL CANCER 181
TABLE 109 SALES OF KEY DRUGS FOR CERVICAL CANCER, 2010 ($ MILLIONS) 182
TABLE 110 CARBOPLATIN SALES, 2010-2012 ($ MILLIONS) 182
TABLE 111 TAXOTERE GLOBAL SALES AND FORECAST, 2010-2012 ($ MILLIONS) 183
TABLE 112 GEMZAR REVENUE, 2010 AND 2011 ($ MILLIONS) 184
TABLE 113 HYCAMTIN SALES, 2010-2012 ($ MILLIONS) 186
TABLE 114 AVASTIN SALES AND FORECAST, THROUGH 2018 ($ MILLIONS) 187
TABLE 115 CERVICAL CANCER: TREATMENT OPTIONS, 1999-2008 (%) 189
TABLE 116 CERVICAL CANCER SURGERY MARKET IN U.S.: SALES AND FORECAST,
THROUGH 2018 ($ MILLIONS) 191
TABLE 117 SURGERY/HYSTERECTOMY FOR CERVICAL CANCER: GLOBAL SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 193
TABLE 118 HYSTERECTOMY FOR CERVICAL CANCER IN U.S.: SALES AND FORECAST,
THROUGH 2018 ($ MILLIONS) 194
TABLE 119 CERVICAL CANCER RADIATION THERAPY MARKET: GLOBAL SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 196
TABLE 120 CERVICAL CANCER RADIATION THERAPY MARKET IN U.S.: SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 197
TABLE 121 KEY FACTS ABOUT CERVICAL CANCER 198
TABLE 122 CERVICAL CANCER VACCINE PATENTS (%) 201
TABLE 123 CERVICAL CANCER CHEMOTHERAPY DRUGS: PATENT EXPIRY 203



LIST OF FIGURES

SUMMARY FIGURE CERVICAL CANCER: GLOBAL MARKET FOR DRUGS AND
DIAGNOSTICS, 2012-2018 ($ MILLIONS) 8
FIGURE 1 MAIN TYPES OF CANCER AND MORTALITY 10
FIGURE 2 CERVICAL CANCER INCIDENCE AND MORTALITY WORLDWIDE, 2008
(THOUSANDS) 86
FIGURE 3 CERVICAL CANCER: EUROPEAN AGE-STANDARDIZED INCIDENCE RATES
PER 100,000 POPULATION AMONG FEMALES, EU27 COUNTRIES, 2008 ESTIMATES 98
FIGURE 4 WORLDWIDE CERVICAL CANCER DIAGNOSTIC MARKET, 2012-2018 ($
MILLIONS) 125
FIGURE 5 GLOBAL CERVICAL CANCER DIAGNOSTIC TESTS: PAP SMEAR TESTS
MARKET AND FORECAST, 2012-2018 ($ MILLIONS) 131
FIGURE 6 WORLDWIDE ESTIMATED NUMBER OF COLPOSCOPY PROCEDURE TESTS
PERFORMED, 2012-2018 (MILLIONS) 139
FIGURE 7 CERVICAL CANCER COLPOSCOPY: GLOBAL MARKET AND FORECAST,
2012-2018 ($ MILLIONS) 140
FIGURE 8 CERVICAL CANCER: COLPOSCOPY TESTS MARKET AND FORECAST IN U.S.,
2012-2018 ($ MILLIONS) 141
FIGURE 9 WORLDWIDE ENDOCERVICAL CURETTAGE (ECC) PROCEDURE MARKET:
SALES AND FORECAST, 2012-2018 ($ MILLIONS) 144
FIGURE 10 WORLDWIDE HUMAN PAPILLOMAVIRUS (HPV) TESTING MARKET: SALES
AND FORECAST, 2012-2018 ($ MILLIONS) 146
FIGURE 11 GLOBAL CERVICAL CANCER PROPHYLACTICS MARKET: SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 157
FIGURE 12 GLOBAL CERVARIX SALES AND FORECAST, 2012-2018 ($ MILLIONS) 162
FIGURE 13 GARDASIL SALES AND FORECAST, 2012 AND 2013 ($ MILLIONS) 163
FIGURE 14 CERVICAL CANCER THERAPEUTIC MARKET: GLOBAL REVENUE AND
FORECASTS, 2012-2018 ($ MILLIONS) 168
FIGURE 15 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 176
FIGURE 16 U.S. CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 176
FIGURE 17 EUROPEAN CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 178
FIGURE 18 JAPANESE CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 179
FIGURE 19 CERVICAL CANCER MARKET: GLOBAL REVENUE AND FORECASTS,
2012-2018 ($ MILLIONS) 179
FIGURE 20 CERVICAL CANCER CHEMOTHERAPY MARKET IN U.S.: SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 181
FIGURE 21 CERVICAL CANCER SURGERY MARKET IN U.S.: SALES AND FORECAST,
2012-2018 ($ MILLIONS) 192
FIGURE 22 SURGERY/HYSTERECTOMY FOR CERVICAL CANCER: GLOBAL SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 193
FIGURE 23 HYSTERECTOMY FOR CERVICAL CANCER IN U.S.: SALES AND FORECAST,
2012-2018 ($ MILLIONS) 194
FIGURE 24 CERVICAL CANCER RADIATION THERAPY MARKET: GLOBAL-SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 196
FIGURE 25 CERVICAL CANCER RADIATION THERAPY MARKET IN U.S.: SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 197

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