Cervical cancer is important to both women and the general public as a whole, so Lucely Cetina Pérez, a professor at the UNAM School of Medicine, says it is important to stress both primary prevention through vaccination and secondary prevention through early detection.
According to the researcher at the National Cancer Institute, it is the second most common type of cancer in women of reproductive age in our country, only after breast cancer, with approximately 10,000 new cases per year and causing between 5,000 and 5,500 deaths each year.
This disease, which is the fourth leading cause of death worldwide and more frequent in countries with limited resources, such as ours and the rest of the Latin American nations, for example, still registers high figures "when there should no longer be any. The goal is to eradicate it, "but we still have a long way to
Cervical cancer is caused by the growth of cancerous cells in the cervix, which can take months or years to spread into other parts of the body.
There are several types, but the most common, accounting for 85 to 90 percent of cases, is squamous cell cancer; other, less common types include adenocarcinoma, adenosquamous, or neuroendocrine cancer, but they are more aggressive.
Cervical cancer is caused by a sexually transmitted infection with the human papillomavirus (HPV) in 99 percent of cases; however, there are other risk factors for cervical cancer, such as smoking, and genital infections, such as chlamydia or gonorrhea.
The use of male condoms helps to prevent genital infections and also reduces HPV infection and, therefore, cervical cancer.
Starting sex at an early age and having sex with multiple partners is also important for the development of HPV infection that can lead to cervical cancer. "All of that adds up, but the triggering cause is the persistence of
Depending on the patient's immune and nutritional status, the virus may persist or may progress. It has been discovered that roughly 30% of infected women develop invasive cervical cancer.
Initially, it is asymptomatic and may go unnoticed. Unfortunately, signs and symptoms appear when the disease is in advanced stages; the main symptoms and signs are transvaginal hemorrhage after intercourse, persistent transvaginal hemorrhage, and pelvic pain, among others. When a person is almost at the end of their life, they may have swelling in their lower extremities or trouble urinating.
When detected in the early stages, 90 percent of the cases are cured; when there are signs and symptoms, the disease is in a clinical stage known as IB2 (that is, when the tumor is confined to the cervix and measures more than four centimeters in diameter); in this and other more advanced stages, the probabilities of cure can range from 50 to 80 percent; and in stages where the disease spreads and reaches other organs, survival decreases to less than 30 percent "even with the best treatments".
The procedure in the early stages is surgical; in locally advanced stages, when the tumors measure four centimeters and up to 10 centimeters, i.e., stages IB2 to Iva, the treatment consists mainly of radio and concomitant chemotherapy, followed by brachytherapy (a type of radiotherapy with a radiation source in the body, inside or near the tumor); when there are metastases, i.e., in advanced stages, chemotherapies and immunotherapy are used. "Even though the new drugs have helped make cures and patient survival rates better, we still have some problems."
Vaccinations and cervical cancer screening
The main aspects of disease prevention are vaccination, early detection of cancer, particularly through Pap smears, and widespread dissemination of information.
In Mexico, it has been reported that there are girls who begin their sexual life at 12 years of age. However, according to the Mexican Official Standard, the application of the Pap smear should be done at the age of 25.
Women should go to the doctor and have the test done at least once a year. In the case of minors, three or four years after the beginning of their sexual life and having close medical surveillance; care must be individualized.
Even though there are other ways to find out what's wrong, the doctor decides if more blood tests, a colposcopy, or other tests are needed to stop the disease from getting worse.
Meanwhile, by public policy, vaccination against HPV is aimed only at girls, but in other countries, there is also the possibility of carrying it out on boys; anal and penile cancer are prevented in them, as well as some anogenital and oropharyngeal warts in both sexes.
In minors, it is advisable to vaccinate them from 9 years of age, and young women up to 23 years of age who have not been vaccinated should be vaccinated, even if they have been exposed to the virus. In males, vaccination is recommended from the age of 13 years.
The "target population" are adolescents and young people who preferably have not had a sexual life, he explains, because the efficacy of the biological vaccine is 97 percent; in those who have been prone to infection, the efficacy decreases to 70 percent, although it is still a "very important" figure. The recommendation for children, adolescents, and young people would be to get vaccinated, although they would have to do it in the private sector.
Lastly, if you notice any symptoms or signs, you should see a doctor right away. Oncology centers are the best places to get the best treatment.