Worth knowing: What is cervical cancer and how to prevent it
According to WHO, cervical cancer ranks fourth. the prevalence among all malignant tumors in women; in 2017, in the US alone, nearly thirteen thousand new cases of cervical cancer will be diagnosed - and more than four thousand women will die from this tumor. Together with the gynecologist Elena Yurievna Akinshina, we understand what kind of disease it is and how to prevent it.
How old is it and how dangerous
Many countries pay special attention to informing the public - for example, detailed statistics on cervical cancer are available for England. From these data it can be seen that the majority of patients are women aged 25-29 years, and the number of cases decreases with age; however, more than 15% of cases are found in women over 65 years of age. At the age of 20-24, the risk of developing cervical cancer is considered very low.
In Russia, according to the International Agency for Research on Malignant Tumors, the incidence of new cases is 15.9 per 100 thousand people. These are quite high rates, higher than in the USA and Europe. Five-year survival for cervical cancer averages 68% - that is, 68 out of a hundred women will be alive five years after diagnosis. True, a lot depends on the stage when a tumor is detected: for early stages, the survival rate for five years is 91%, and for the latest ones - only 17%. Logic suggests that timely diagnosis in this case is a matter of life and death.
Why does it arise
The main cause of cervical cancer is the human papillomavirus (HPV). We have already talked about it in detail; Recall that there are more than one hundred types of this virus, some of which are oncogenic. Less dangerous types of HPV cause the formation of papillomas (warts) on the skin or mucous membranes, but the most dangerous, oncogenic viruses cause cancer of the cervix, anus, vulva, vagina and penis. A few years ago, actor Michael Douglas reported that the pharyngeal cancer diagnosed in him could be associated with oral sex - in this case, it is a question of a tumor caused by the human papilloma virus.
HPV is transmitted primarily through sexual contact, and most people become infected soon after the onset of sexual activity. Seventy percent of cancers and precancerous changes in the cervix are caused by two types of HPV (16 and 18). Additional risk factors include chronic inflammatory processes associated with infections or poor hygiene, frequent delivery, a large number of cervical ruptures or non-dried ruptures, as well as smoking, reduced immunity, a large number of partners, and early onset of sexual activity. An important risk factor is dysplasia of the cervical epithelium, in which the development of normal epithelial cells is impaired; dysplasia can be detected during a pelvic exam.
How often should be examined
Three key methods are used to diagnose cervical cancer: cytology (the so-called Pap test), cervical staining with acetic acid solution, and a high oncogenic risk HPV test. Recommendations from the American Cancer Society reveal not only cervical cancer in its early stages, but also precancerous conditions that can be treated in time.
Screening should begin at the age of twenty-one — and before the age of twenty-nine, a Pap-test is required every three years. After that, from thirty to sixty-five years, a Pap test is recommended in combination with an HPV test every five years (but, alternatively, you can continue to take the Pap test every three years). With high risks due to reduced immunity (for example, with HIV infection, after organ transplantation or long-term use of steroid hormones) screening needs to be done more often - the doctor determines the exact recommendations.
These guidelines apply to everyone - including those who are vaccinated against HPV and those who do not plan to have more children. It is important that annual screening is not considered necessary: a repeated Pap test in six months or a year is carried out only for those who have already received unfavorable results.
When to run to the doctor
The screening described above needs to be done once every three years if nothing bothers you - but the alarming symptoms should be the reason for an urgent visit to the gynecologist. This is an unexpected bleeding - in the middle of the menstrual cycle or after sex, watery discharge, blood with an unpleasant smell, pain in the pelvic region, including during sex. Although at a young age (20-24 years) cervical cancer is quite rare, "unscheduled" bleeding - this is what you need to see a doctor always.
If cervical cancer has been diagnosed in you or in a loved one - you need not panic and do not look for alternative methods of treatment, but strictly follow the instructions of the doctor. Treatment depends primarily on the stage of the disease and may include surgery, chemotherapy, radiation and immunotherapy.
How to prevent
Prevention of cervical cancer is a whole range of actions, primarily the vaccination of girls and boys aged 9-14 years against HPV. This is the most effective option, but in women vaccination can be carried out up to 45 years. The vaccine is effective even in cases where oncogenic HPV types have already been identified, but there are no oncological changes in the cells. Of course, the use of condoms, smoking cessation and the general maintenance of good health are important for prevention.
In 2016, the Roswell Park Cancer Institute in the United States conducted a study on the effect of physical activity on the risk of developing cervical cancer. It turned out that the risk of developing a tumor is 2.5 times higher in women who were not involved in sports than in those who actively trained at least four times a month.
Photo: Africa Studio - stock.adobe.com, Sebastian Kaulitzki - stock.adobe.com
