Obstetrics and Gynecology Specialist Op.Dr.Esra Demir Yüzer gave important information about the subject. Cervix (cervix) is the neck of the uterus that opens to the vagina. The cervix not only protects the uterus from infections, but also acts as a door that ensures that the baby growing inside the uterus remains in the uterus during pregnancy.
Cervical cancer is the second most common cancer in women under the age of 45 worldwide. Cervical cancer comes in the third place after breast and lung cancer in cancer deaths in women. Cervical cancer is the 2th most common cancer among all cancers in Turkey. In our country, 3 women are diagnosed with cervical cancer every year.
What is Cervical Cancer?
Cervical cancer occurs when cervical cells lose their normal structure and begin to grow and multiply uncontrollably.
What are the Causes of Cervical Cancer?
It has been determined that 99.7 percent of all cervical cancers contain HPV DNA. In scientific publications, it is stated that the presence of HPV is necessary for the development of cancer in the cervix, but it is not sufficient. In other words, some co-factors are needed for HPV infection to cause cancer. It shows that HPV type is definitely high-risk for cancer and all 3 types are probably high-risk. The cause of cervical cancer is human papillomavirus (HPV). There are over 100 types of HPV. Two types of HPV (HPV 16 and 18) cause the majority of cervical cancer cases.
What are the Symptoms of Cervical Cancer?
Cervical cancer usually does not show any symptoms, especially in the early stages. That's why it's so important for women to go to the doctor for regular screening.
- When symptoms occur, the following complaints may occur:
- Pain or bleeding during or after sexual intercourse
- Groin pain after gynecological examination
- Unusual, smelly discharge from the vagina
- Spots of blood or light bleeding outside of normal menstruation
These complaints may also occur in some serious diseases other than cervical cancer. For this reason, symptoms should be evaluated quickly by a doctor.
Today, more than 99% of cervical cancers are thought to be caused by HPV. HPV is a common virus that will infect more than two-thirds of sexually active women at some point in their lives.
Infection with HPV does not necessarily mean that you will get cervical cancer. The immune system clears 12% of this virus from the body within 18-90 months after being infected with this virus. In the 10% section where HPV cannot be removed, formations such as pre-cancer and cancer can be encountered in the cervix within 5-10 years.
Other risk factors for cervical cancer include:
- First sexual intercourse at an early age
- Having many sex partners
- Too many children
- Smoking (smoking damages cervical cells, making them more vulnerable to infection and cancer)
- produces chemicals that can bring
- Using birth control pills
- HIV infection (reduces the body's ability to fight HPV infection and early forms of cancer)
By avoiding these risk factors, women can reduce their risk of developing cervical cancer. Cervical cancer rarely develops in women without these risk factors.
Men's use of condoms during sex can help women protect themselves from HIV and other sexually transmitted diseases; however, condoms do not fully protect against HPV. Using a condom reduces the infection rate by about 70%. This is because HPV can spread through physical contact with any infected area of the body.
Screening in Cervical Cancer
We recommend that women have their first cervical cancer screening at age 21, regardless of the age at first sexual intercourse. Then, we consider it appropriate to follow up with cervical cell screening test, that is, cervical pap smear test, every two or three years. Over the age of 30, cervical pap smear and HPV DNA (PCR) test can be evaluated together. If both tests come back negative, screening can be done every five years.
Diagnosis in Cervical Cancer
The Pap smear test is used to screen for cervical cancers and cervical precursor cancers. Since cervical cancer does not show any symptoms in its early stages, regular cervical pap smear test is very important to catch early stage cervical cancers.
Pap smear test is performed by taking cell samples from the cervix with the help of a plastic brush during vaginal examination. If abnormal cells or precancerous cells are detected in the cervical pap smear test, the cervix is enlarged and examined by a procedure called colposcopy. A biopsy can be taken from suspicious areas and examined in detail.
Treatment methods vary according to the stage of the disease. While methods such as Cervical cone biopsy (conization), Loop electrosurgical excision procedure (LEEP), Cryosurgery are used for cleaning the precancerous lesions, surgeries involving the removal of the uterus and ovaries and the surrounding tissues where the cancer has spread can be performed for cervical cancers.
In some cases, chemotherapy or radiotherapy may be added to the surgical treatment.
Preventing Cervical Cancer
Two new vaccines are available in Turkey that provide protection from the two most dangerous types of human papillomavirus (HPV), which causes the majority of cervical cancer cases (HPV 16 and 18). These vaccines can prevent up to 70% of cervical cancer cases, but they cannot prevent every virus-related infection that causes cervical cancer. In order for the vaccine to be effective, it must be administered in 6 or 2 doses within 3 months. The World Health Organization (WHO) also recommends the vaccination of girls between the ages of 9-13, that is, vaccination before sexual intercourse. The vaccine is a preventive vaccine, not a curative one. However, it should be kept in mind that regular Pap-Smear testing against cervical cancer should continue, even if the vaccine is given.