Cervical cancer threatens women’s health and life, but in fact, relative to lung cancer, liver cancer, stomach cancer and other more dangerous cancers, cervical cancer can be said to be “not too cold” killer, and even considered to be a preventable and curable tumor. Indeed, if early detection and timely treatment, cervical cancer patients have a five-year survival rate of more than 90%.
For cervical cancer, a “three-level prevention and control system” has been established. The last stage of the third-level prevention and control is to cure the disease, that is, the treatment of various stages of cervical cancer, including surgery and radiation therapy, to reduce mortality; secondary prevention and control refers to cervical cancer screening and precancerous lesions. Treatment; primary prevention and control refers to the vaccination of cervical cancer vaccine (or “HPV vaccine”).
In the context of the first prevention and control of cervical cancer in China (vaccination), secondary prevention and control is also very important for cervical cancer screening. Even if the first-level prevention is widely carried out in the future and the vaccine is generally vaccinated, it cannot replace the secondary prevention and control.
First, little is known about cervical cancer
When it comes to cervical cancer, more than 90% of the women surveyed said that they know more or less, but most people do not know much. Most people only say “heard”. Typical symptoms of cervical cancer – after the same room or after gynecological bleeding (contact bleeding), no one can answer. Although cervical cancer is the only cancer that determines the cause, only half of women know that high-risk human papillomavirus HPV is a direct cause of cervical cancer.
But there is another extreme, some people directly equated HPV infection and cervical cancer. This is of course wrong. If you do not get HPV, you will not get cervical cancer. However, cervical cancer is not caused by HPV. Only long-term and continuous contact with HPV can cause cervical precancerous lesions and cervical cancer. In fact, women have a 40% or higher probability of encountering HPV in their lifetime. It usually appears as a visitor and mostly leaves. But if your condition is not good (immunity decline), the environment is suitable (multiple partners, unclean sex life), it will overcome, “settle”!
Second, for the screening, there is a misunderstanding of “not sick or not”
When asked in the survey, “When should women receive ‘two cancer screenings?’, 57% of women think that they will wait until the body has some symptoms of discomfort before screening. It can be seen that “not sick or not” is still a common misunderstanding.
In fact, precancerous lesions of the cervix often have no obvious clinical manifestations. Patients with bleeding and odorous vaginal discharge seen in gynecological clinics have mostly reached the advanced stage, and the latter will greatly reduce the survival rate of patients. On the other hand, some cervical lesions don’t look too good, but it is not a precancerous lesion, such as a severe “smashed” appearance of the cervix, and there is contact bleeding, but not necessarily precancerous lesions; and some people see the cervix It is very smooth, it seems that there is no problem at all, but the screening results suggest a precancerous lesion. There is a saying that “seeing is believing, the ear is imaginary”, but in the case of cervical disease, seeing is not true, it is necessary to rely on regular screening to find out.
Cervical cancer has a long precancerous lesion process. It takes several years from the first, second and third grades of cervical intraepithelial neoplasia (CIN), and it takes several years to develop into cancer. If there are multiple opportunities to receive regular Screening for cervical cancer may block this process and kill cervical cancer in the cradle. Obviously, “not sick or not” is not advisable.
Third, the awareness of screening, more chaotic
In the perception of screening methods and frequency of cervical cancer, the concept of female friends seems to remain “yesterday.” Still 16% of respondents mistakenly believe that traditional Pap smear screening is more accurate and effective for cervical cancer screening, and less than half (48%) of respondents recognize cervical thin-layer liquid-based cytology ( TCT) combined with HPV testing is more accurate and effective.
How often is it best to screen once? In 2017, under the guidance of the Department of Maternal and Child Health Services of the National Health and Family Planning Commission, the Guidelines for Comprehensive Prevention and Control of Cervical Cancer prepared and published by the Women’s Health Care Branch of the Chinese Preventive Medicine Association made the following recommendations:
Women aged 25 to 29 are screened every 3 years for cervical cytology. If the test result is negative, the screening is repeated every 3 years.
For women between the ages of 30 and 64, combined cervical cytology and HPV testing are preferred, and double negative results are repeated every 5 years. If the cervical cytology is performed separately, the negative screening is repeated every 3 years; if the HPV primary screening is performed separately, the negative screening is repeated every 3 to 5 years.
Women with the following high-risk factors need to shorten the screening interval: HIV infection, immunosuppressive immunosuppression (such as receiving solid organ transplants), history of exposure to diethylstilbestrol before birth, CIN2, CIN3 or cervical cancer after follow-up.
It is generally considered that the age of termination screening is 65 years old (provided that the screening results were negative in the past ten years, negative for three consecutive cytological tests or negative for two combined screenings).
The main concern of TCT is whether cervical cells have found abnormal changes under the pathogenic factors. It is the result; HPV testing is more concerned with the presence of high-risk virus infections that may lead to cervical lesions and cervical cancer. The sensitivity of TCT is low, depending on the reading level of cytologists, and it is necessary to make up for the deficiency by increasing the number of screenings; HPV detection is (semi) automated operation, high sensitivity, can significantly reduce the number of screenings, but specificity Not as good as liquid-based thin layer cytology. If there are conditions, a combination of two screening methods for joint screening can obtain more accurate screening results.
In general, I hope that women can pay attention to themselves when they are healthy. From now on, they will take the initiative to obtain cervical cancer screening knowledge, and regularly accept the “two cancers” accurate screening, stay away from risks and embrace health!
Tips: Screening recommendations for breast cancer
“Guidelines and Guidelines for Breast Cancer Diagnosis and Treatment of China Anti-Cancer Association (2017 Edition)” (excerpt):
Women aged 40 to 45 have a mammography screening every year, and a dense breast is recommended for joint examination with B-ultrasound.
Women aged 45 to 69 have a mammogram every 1 to 2 years, and a dense breast is recommended for joint examination with B-ultrasound.
Women over the age of 70 have a mammogram every 2 years.
Screening for high-risk groups is recommended in advance (less than 40 years old). In addition to X-ray examination, screening methods can also be applied to imaging methods such as MRI.