In developed countries, cervical cancer is the tenth most common cancer among women’s cancers (9 in 100,000 women) and the third most common among gynecological organs. Conversely, in developing countries it is the second most common cancer in women in terms of incidence (18 per 100,000) and mortality (10 per 100,000).
This difference is of course due to the organized system of care and prevention with the Pap test that is applied in developed countries. Vaccination for HPV (Human Papilloma Virus) is also an important help in the fight against cervical cancer, since it has been proven that 99% of cervical cancers are due to this virus.
A typical example is Australia, where vaccination rates exceed 70%, resulting in a 38% reduction in precancerous lesions of cervical cancer.
The average age of diagnosis is 48 years, while risk factors related to the possibility of HPV infection are summarized below:
Although the majority of cervical cancers are related to HPV, only a very small percentage of women who have been exposed to the virus will develop cancer. Indicatively, it is estimated that up to 80% of sexually active women will be infected with HPV by the age of 50. However, simple infection with the virus is not enough, as it must belong to specific strains (high risk) which have been proven to lead to the appearance of cervical cancer.
These strains have been found to be over 15 with types 16 and 18 responsible for over 70% of cervical cancer cases. After all, these two types are what the commercial vaccines target.
Most infections with the HPV virus are transient, since often the body itself develops antibodies and eliminates the virus in time. In addition, simply the presence of the virus in the cervix is not sufficient in itself for the development of cancer. If the presence of the virus persists over time, then it may develop into a precancerous lesion and later into cancer, a process that takes an average of 15 years. At this point, the prevention with the Pap test acquires its meaning, since we can thus prevent any alteration and give the appropriate treatment before it develops into cancer.
Cervical cancer in the early stages is asymptomatic and can only be suspected with a Pap test.
Common manifestations may also be painless, spontaneous vaginal bleeding, or after sexual intercourse. In advanced stages of invasive cervical cancer, foul-smelling vaginal fluids, pelvic pain, pressure problems in the bladder, ureter (hydronephrosis which can even lead to kidney loss) or even in the intestine may appear.
If there is a suspicion of cervical cancer, either clinically by the gynecologist, or microscopically by the Pap test, then for the final diagnosis it will be necessary to perform a colposcopic examination by the gynecologist with biopsies and a cone-shaped excision of the cervix.
From there, after the final diagnosis, the staging is carried out which includes the clinical examination under anesthesia and some imaging tests such as CT or magnetic resonance imaging, or even Pet-scan, which will give us information about the stage of the extension.
Of course, the treatment will be proportional to the stage, with a better prognosis in the early stages, as is logical.
Each case is unique, the treatment of which takes into account many factors such as the stage, age, desire of the woman, general state of health, etc.
Special treatment is needed for women who have not given birth, where if the conditions allow it, we apply conservative surgical treatment so that they can immediately carry out a pregnancy.
Surgery (conoid excision, simple hysterectomy, radical hysterectomy), radiotherapy, chemotherapy or their combination are the usual treatments recommended.
Stage 1: The cancer is confined to the cervical region with a 5-year life expectancy of around 95%.
Stage 2: The cancer has spread beyond the cervix but has not spread to the lower part of the vagina or pelvic wall with a 5-year life expectancy of around 70%
Stage 3: Cancer has spread to the lower part of the vagina and/or the lateral pelvic wall and/or causes hydronephrosis and/or non-functioning kidney and/or lymph nodes with a 5-year life expectancy of over 40%.
Stage 4: Cancer has spread beyond the pelvis and invaded the bladder and/or bowel with a 5-year life expectancy of around 15%.
From the above, it is understood that cervical cancer is a cancer that affects all women regardless of age and that, thanks to the Pap test, can be prevented at a pre-cancerous stage or even at an early stage, with excellent cure rates and quality of life.
This is also the meaning of regular visits to the gynecologist.
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One day diagnosis and treatment. (No touch, Diagnostic and Operative Hysteroscopy)
Personalized choice of treatment.
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Urinary incontinence and pelvic prolapse treatment.
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