Incidence, mortality and risk factors of cervical cancer

Cervical cancer is a malignancy of the cervix, which located between the lower part of the uterus and vagina. In Indonesia, cervical cancer is the second most common cancer in women following breast cancer, up to 36,000 new cases in 2020.

High risk type of Human Papilloma Virus (HPV) is the main cause of cervical cancer, which can also cause cancer of vulva, vagina, larynx, and oropharynx; while the low risk type can cause disease such as non-malignant genital warts. HPV exposure could prevented by the immune system to case a disease, but in some cases, it stays inside the body and could develop into cancer cells. Cervical cancer could be prevented and detected earlier by regular pap smears, HPV-DNA, Visual Inspection with Acetic Acid (VIA) examinations, and also vaccination to protect from HPV infection. Risk factors are young-age sexual intercourse, promiscuity, prior sexual transmitted disease, smoking, and immunocompromised condition. Symptoms occur are bleeding, vaginal bleeding out of menstrual cycle, post-menopausal bleeding, post-coitus bleeding, smelly vaginal discharge, and pelvic pain which usually occurs in an advanced stage.

 

This disease can be treat with options based on disease’ stage from removal of uterus and lymph nodes, to chemotherapy and radiation therapy. During early stage, the 5-year survival rate reaches 90%. If proliferation into surrounding organs or lymph nodes occur, the 5-year survival rate decreased into 50%. Even after completing the cancer treatment, regular check-up is still recommended to determine the possibility of recurrence. Around one-third of women that have completed treatment, experience relapse with 1-22% of stage I-II and 28-64% of stage II-IV.

It's important for women to carry out early detection and prevention of cervical cancer, aside from early recognized, it also prevent from developing into higher stages of disease, increasing the cure rate expected. Physicians will confirm the presence of HPV genetic materials (DNA) in the cervix of woman suspected having a cervical cancer by pap smear examination as one of the methods. It is not needed to wait for occurring symptoms to check with a gynaecologist. Scheduling a regular check-up to gynaecologist since teenage are well recommended.