Don’t be afraid of cervical cancer. Do these three things to stay away from it!

Cervical cancer is the most common malignant tumor of the female reproductive system in my country. The annual incidence rate is second only to breast cancer, accounting for 28.8% of the world's new cases. About 50,000 people die from cervical cancer each year, accounting for 17.4% of the world's cervical cancer deaths, and has become the second largest cancer among Chinese women. The incidence and mortality rates of cervical cancer in my country are gradually increasing, with a trend of younger people. The main reason for this phenomenon is that my country currently lacks awareness of cervical cancer and lacks awareness of prevention and treatment.

1. What are the symptoms of cervical cancer?

Early cervical cancer usually has no obvious symptoms and signs. As the disease progresses, the first thing that appears is contact bleeding, which is often found after sexual intercourse or gynecological examination. Further development will cause irregular vaginal bleeding or vaginal discharge with a fishy smell. After the tumor spreads, it will cause metastasis to adjacent organs and even the whole body, such as ureteral obstruction, ascites, bone metastasis, etc. Most of the clinical findings are already in the late stage.

2. What causes cervical cancer?

Cervical cancer is currently the only malignant tumor with a clear cause. The causes of cervical cancer include: persistent infection with high-risk human papillomavirus (HPV), multiple sexual partners, premature and frequent sexual activity or too many births, and low immune function, among which persistent infection with high-risk HPV is the main cause.

3.What is HPV ?

HPV is called human papilloma virus, a spherical DNA virus that can cause proliferation of squamous epithelial cells in human skin and mucous membranes. It is widely present in nature, and more than 130 types have been isolated, divided into high-risk and low-risk types. A multicenter study showed that about 85% of cervical squamous cell carcinoma in China is related to HPV16 and 18 infection.

(Photo source: ZCOOL)

According to surveys, almost every woman has the chance to be infected with HPV in her lifetime, but it is a transient infection. But don't panic too much. Most women can clear the virus through their immune system within 12-24 months after HPV infection. Only 3-5% of patients cannot clear the virus and present a persistent HPV infection state, and less than 1% of patients develop precancerous lesions and cervical cancer. It takes 5-10 years from HPV infection to cervical cancer. During this period, early screening, early detection, vaccination and treatment can block the progression of the disease.

HPV typing and its clinical significance

4. What are the ways to prevent cervical cancer?

The World Health Organization (WHO) recommends that the most effective measure for the prevention and control of cervical cancer is tertiary prevention. The combination of these three measures can effectively prevent and reduce the incidence and mortality of cervical cancer.

Primary prevention: HPV vaccine: It is the world's first vaccine to prevent cancer and was approved by the U.S. Food and Drug Administration (FDA) in June 2006. There are currently three types of HPV vaccines on the market: bivalent, quadrivalent, and nonavalent. The comparison is as follows:

Comparison of HPV vaccines bivalent, quadrivalent, and nonavalent

Note: CFDA: China Food and Drug Administration of the People’s Republic of China.

(Photo source: Visual China)

At what stage is vaccination most effective?

Two stages: 1. Before the first sexual intercourse; HPV is mainly transmitted through sexual intercourse, and sexual intercourse increases the risk of infection. HPV vaccine prevents certain types of high-risk HPV viruses by producing antibodies in advance. The best age for vaccination recommended by WHO is 9-14 years old. The earlier the vaccination, the higher the protection efficiency.

2. HPV test has turned negative: People who have had sex may have been infected with a certain type of HPV virus. At this time, the effect of vaccination becomes worse. If the HPV test has turned negative, vaccination can prevent repeated infection. Therefore, it is recommended that eligible people get vaccinated as soon as possible.

Is the vaccination effective for life? Do I need to be vaccinated again later?

No need for re-vaccination. According to data from the US Centers for Disease Control and Prevention, as of 2019, all three HPV vaccines have shown good immune persistence and long-term protection. The vaccine-related antibody positivity rate of the subjects was still >90% 12 years after the 2-valent and 4-valent vaccines and 7.6 years after the 9-valent vaccine, and no HPV vaccine-related precancerous lesions were found. The HPV vaccine has only been on the market for 17 years since 2006. Whether it has a longer protection period or even lifelong effectiveness can only be answered by time.

Secondary prevention: "Three-step" screening for cervical cancer - cytology screening, colposcopy, and cervical biopsy. The initial screening methods include cytology screening ( TCT ) and HPV **** examination. Those with abnormal results in the initial screening need to undergo colposcopy to confirm whether there are any abnormalities. For those with abnormalities, cervical tissue should be taken for pathological biopsy to determine whether there are cervical precancerous lesions or cervical invasive cancer. Once confirmed, treatment should be started as soon as possible.

The "Guidelines for Comprehensive Prevention and Control of Cervical Cancer in China" recommends that women begin cervical cancer screening at the age of 25 (after they start having sex).

Cervical cancer screening for the general population

Note: Sufficient negative screening results in the past: 3 consecutive negative cytology results or 2 consecutive negative combined screening results in the past 10 years, and the most recent screening was within 5 years.

HIV-infected patients, those in immunosuppressed states (such as patients undergoing solid organ transplantation), and those who have previously received treatment for CIN2, 3 or cervical cancer should be screened more frequently than the general population.

If vaginal bleeding occurs after sexual intercourse, or if there is unexplained abnormal vaginal bleeding or increased vaginal discharge with or without odor at any age, you should seek medical attention promptly to determine whether there is a possibility of cervical lesions.

Level 3 prevention: Early diagnosis and treatment of precancerous lesions: mainly timely and correct intervention and management of high-grade cervical epithelial lesions (CIN). Once the cervix is ​​diagnosed with precancerous lesions or cervical cancer of any stage, it should be treated by a gynecological oncologist.

Through the above introduction, everyone's understanding of cervical cancer has been improved. Cervical cancer is a preventable and treatable malignant tumor. Doing three things in the three-level prevention of cervical cancer can effectively reduce the incidence and mortality of cervical cancer and stay away from cervical cancer.

Expert introduction

Hou Yanli, attending physician of the Oncology and Hematology Department of Chongqing Traditional Chinese Medicine Hospital, member of the Popular Science and Health Education Working Committee of the Chinese Medical Education Association, has been engaged in oncology work for ten years, mainly engaged in the diagnosis and treatment of various malignant tumors. During her clinical work, she was responsible for the promotion of popular science knowledge on oncology in the department and wrote and published many popular science articles.