Symptoms
Early cancer does not cause symptoms for a long time. Only when it progresses do vaginal bleeding, discharge, and pain during sexual intercourse occur. Cervical cancer is rarely seen in women younger than 20. Most patients are between 30 and 50 years old.
Causes
Infection with human papillomavirus (HPV), especially types 16 and 18, plays a critical role in the development of the disease. However, cervical cancer is a multifactorial process and involves genetic, hormonal, immunologic, and environmental influences in addition to viral infection. Not every HPV infection ends up as cancer. A cervical cancer develops from a precancerous stage and is only formed after 10-20 years. Risk factors for HPV infection:
- Early sexual activity
- Frequently changing sexual partners, co-infections with other sexually transmitted diseases, e.g., genital chlamydial infection, genital herpes
- Type of contraception: no condoms, long-term use of oral contraceptives.
Additional risk factors for cervical cancer:
- Smoking
- Multiple previous pregnancies
- Taking immunosuppressants or glucocorticoids, suppression of the immune system (eg, after transplantation, HIV infection).
Transfer
The transmission of the viruses occurs during sexual intercourse.
Complications
Cancer treatment can lead to infertility. The biggest problem of cervical cancer is recurrence after treatment. When the cancer recurs, it usually affects the uterus, vagina, connective tissue structures of the pelvic cavity, bladder, ureter, rectum, and ovaries. Malformations of the genital tract may occur, and offshoots may form in the dorsal vertebrae, ribs, pelvis, and skull.
Diagnosis
Diagnosis is made by gynecologic treatment.
Prevention
The following measures are recommended for prevention or early detection:
- HPV vaccination (Gardasil, Cervarix) against subtypes of HP viruses for girls see under HPV vaccination.
- Consistent use of condoms
- Early detection measures such as visual inspection of the junction between the uterus and vagina and HPV testing. The Papanicolaou test (Pap smear) is an effective screening method for early detection of cervical cancer by staining a cell smear of the cervix.
- Do not smoke
Treatment
The goal of treatment is the removal of the degenerated tissue. In this process, recurrence of cervical cancer is almost impossible to prevent.
