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Women Health Specialist Assoc. Fatih Güçer gave information about cervical cancer.
Cervical cancer develops from the tissue lining the cervix. The cervix is the lower part of the uterus. The cervix is the part of the uterus that connects the body part of the uterus that carries the fetus to the vagina. The closest part of the cervix to the uterus is called endocervix and the part close to the vagina is called ectocervix. Cervical cancer often develops in the same confrontation.
Cervical cancer is frequently seen in middle age. Half of the women diagnosed with cervical cancer are between 35 and 55 years old. It is rarely seen in women under 20 years of age. Although cervical cancer occurs in young women, many older women are unaware that they are at risk at their age. A little more than 20% of women diagnosed with cervical cancer are over 65 years of age. It is important for older women to have a Pap test until at least 70 years of age.
The 5-year survival rate in the earliest stage of cervical cancer is almost 100%. The survival rate is 92% if the cancer is slightly advanced but has not spread to lymph nodes (nodes) or other sites. Considering all stages together, the 5-year survival rate is approximately 73%.
What are the risk factors?
There are several factors that increase the risk of developing cervical cancer. Women who do not have any of these risk factors rarely develop cervical cancer. Even if these risk factors increase the likelihood of cervical cancer, many women with these risks do not develop it.
Risk factors for cervical cancer include:
Human papillomavirus (HPV) infection: The most important risk factor for cervical cancer is infection with HPV. It is considered that having received HPV is almost essential for the development of cervical cancer. Some forms of sexual behavior increase a woman's risk of receiving HPV:
- Early sexual intercourse
- Existence of many sexual partners
- Establishing sexual intercourse with uncircumcised men
HPV can exist for years without symptoms or warts. Therefore, HPV can be passed on to the sexual partner without realizing it. Recent studies have shown that condoms are not very effective in preventing HPV transmission. The reason for this is the silent shelter of HPV in the sexual area which is not covered with condoms.
Cigaret: Women who smoke are at twice the risk of non-smokers. Smoking also exposes many tissues of the body to chemicals that cause cancer. These harmful substances can be absorbed from the lungs and carried with blood to various organs. Smoking by-products were found in the cervical secretions of women who smoke. These products are thought to contribute to cancer formation by disrupting the DNA of cervical cells.
HIV infection: HIV is the virus that causes AIDS. The risk of HPV infection increases as this virus weakens the body's immune system. The immune system has the effect of destroying cancer cells and slowing the growth and spread of cancer. In women with HIV infection, cervical precancers may turn into cancer faster than normal.
Chlamydia infection: Chlamydia is a relatively common bacterium that is transmitted by sexual contact and can infect the female genital system. Infection can be silent in most women without symptoms and can only be noticed during cervical sampling.
Diet: Poor diet of fruits and vegetables poses a risk for cervical cancer.
The risk was also high among women who were overweight.
Birth control pills: Taking long-term birth control pills increases the risk. Some studies have shown increased risk in use for 5 years or more. In one study, it was found that the risk increased 4 times in use for more than 10 years. Consider the benefits of birth control pills and this relatively low risk increase, discuss with your doctor when choosing whether to use it. Women with multiple sexual partners should use condoms to protect against sexually transmitted diseases, no matter which contraceptive method they use.
Multiple pregnancy: The risk of cervical cancer is higher in women with multiple myocardial infants.
Low socioeconomic level: It is known that women with low socioeconomic status are at risk because they do not have adequate access to health services including regular PAP testing and treatment of pre-invasive cervical diseases. These women may also be in the risk group because they are often undernourished.
Family history of cervical cancer: Recent studies have found that cervical cancer is more common in women with cervical cancer in their mother or sisters. Some studies have attributed this to a hereditary disorder that causes problems in the fight against HPV infection.
What are the symptoms?
Precancers and early stage cancers of the cervix usually do not show signs or symptoms. Symptoms usually begin when the cancer is invasive and spreads to surrounding tissues. The most common symptom is unexpected vaginal bleeding.
An unexpected, different vaginal discharge from menstruation may be the first symptom. This discharge may be in the form of spotting or mild bleeding and may occur between the two. In addition, menstrual bleeding may be longer and more severe. In menopause, it can also be manifested as bleeding and excessive vaginal discharge.
Bleeding after examination, sexual intercourse or vaginal douche, and pain during sexual intercourse may also indicate cervical cancer.
For early diagnosis…
Early diagnosis can usually be made by regular PAP tests. Attention to signs and symptoms of cervical cancer will prevent delay. Early detection usually increases the chances of success. In the world, women who do not have regular PAP tests have a much higher mortality rate from cervical cancer. Cervical cancer is the leading cause of cancer death in women in many developing countries. In these countries, cancer is usually advanced when diagnosed.
How is the diagnosis made?
Medical history and physical examination: The patient's and family's medical history, cervical cancer symptoms and risk factors will be asked. General physical examination and examination of the lymph nodes are performed especially to see if the cancer has spread.
Other tests for women with abnormal cervical cytology (cell examination):
Since the PAP test is not a diagnostic test but only a screening test, additional tests (colposcopy and biopsy, sometimes endocervical curettage) are necessary to determine whether there is a change in precancerosis or cancer when the result is abnormal. When SIL or atypical glandular cells are seen in the PAP test, these tests are recommended.
Colposcopy: In colposcopy, the doctor looks at the cervix with a device called a colposcope with magnifying lenses. The surface of the cervix can be traced close and clearly.
Cervical biopsies: There are various biopsy methods used to diagnose precancer and cancers of the cervix. Some of these methods may even be sufficient for early removal of cervical precancers or early cervical treatment by providing complete removal of abnormal tissue.