Chances of Curing will be greater if Cervical Cancer is Detected early, read more!

Cervical cancer

Cervical cancer is a malignant disease originating from the cervix. The cervix is ​​the lower third of the uterus that is connected to the vagina.

Cervical cancer is the second most common cause of cancer in women. In 2018 an estimated 570,000 women suffered from cervical cancer and around 311,000 died from cervical cancer. In Indonesia, cervical cancer ranks 2nd out of the 10 most cancers with an incidence of 12.7%. According to the Indonesian Ministry of Health at this time, the number of new women with cervical cancer ranges from 90-100 cases per 100,000 population with 40,000 cases per year.

Cervical cancer can be caused by the HPV (Human Papilloma Virus), especially sub-types 16 and 18 which are generally transmitted through sexual intercourse. The risk factors for cervical cancer include:

- Sexual activity at a young age

- Multiple sexual partners or have sex with men who change partners frequently

- Smoking

- Sexually transmitted disease

- Immunity disorders

The development of invasive cervical cancer is initiated by the presence of HPV infection which then progresses to precancerous lesions. In general, these precancerous lesions are asymptomatic. When it has become invasive cancer, the symptoms that appear generally include abnormal vaginal bleeding (contact bleeding, during intercourse), pain during intercourse, and vaginal discharge. At a more advanced stage, symptoms can progress to low back or abdominal pain to urinary disturbances. To diagnose cervical cancer requires a thorough examination of the condition of the uterus, vagina, rectum, and anus and additional investigations such as cervical biopsy, as well as several other examinations (CT scan, MRI, PET scan, etc.) to determine the spread and stage of cervical cancer.

Efforts that can be made to prevent cervical cancer include HPV vaccination and routine screening for early detection of precancerous lesions. To detect the presence of precancerous lesions on the cervix, screening examinations can be carried out, including Pap smears, visual inspection with Acetic Acid (IVA) or Lugoliodin (VILI), and HPV DNA tests.

Recommendations for screening tests to detect lesions in cervical cancer are:

Age <21 years old : no need for screening
Age 21-29 years: Pap smear examination every 3 years
Age 30-65 years: Pap smear every 3 years or Pap smear and HPV test every 5 years
Age >65 years : no need for screening if previous test results were normal

Treatment of cervical cancer depends on the stage of cancer and the patient's condition. Actions taken for the treatment of cervical cancer may include surgery, chemotherapy, radiotherapy, or a combination of the three. The prognosis of patients with cervical cancer also depends on the stage of the disease. Chances of cure will be greater if cervical cancer is detected early. Therefore, it is recommended to do cervical cancer screening regularly and see a doctor immediately if you experience the above symptoms.

reviewed by : dr. Ali Budi Harsono, Sp.OG, K-Onk

Reference:

Cervical Cancer Management Guide. National Cancer Prevention Committee. Jakarta. 2017
Zhang S, et al. Cervical Cancer: Epidemiology, risk factors, and screening. Chin J Cancer Res. 2020; 32(6): 720-728
Ngoma M, et al. Cancer prevention: cervical cancer. Ecancermedicalscience. 2019; 13:952
Updated Cervical Cancer Screening Guidelines. American College of Obstetricians and Gynecologists. April 2021.
Boardman CH, et al. Cervical Cancer. Medscape. 2021
Sachdev P. Cervical Cancer. WebMD. 2021