Cervical cancer can be prevented

The need for an integrated approach to the prevention and control of cervical cancer in the population, which is an important public health problem, is underlined by EODY, as the month of January has been designated as international cervical cancer awareness month.

The risk of cervical cancer increases significantly for women over the age of 30. Cervical cancer can be prevented and cured, experts emphasize, as long as it is detected early and treated effectively.

According to the World Health Organization (WHO), cervical cancer is the fourth most common cancer in women worldwide, with approximately 604,000 new cases in 2020. Of the estimated 342,000 deaths from cervical cancer in 2020, approximately 90% of these occur in low- and middle-income countries, while 80% of cases worldwide occur in developing countries. This difference is mainly due to women’s limited access to health care and prevention services, resulting in late diagnosis and untimely intervention.

Regarding the European Region of the WHO and Greece in particular, according to the estimates of the Global Cancer Observatory of the World Health Organization and the International Agency for Research on Cancer, in 2020 it was estimated that cervical cancer is the 10th most common malignancy in women, while for women aged between 15-44 years it is the 3rd most common malignancy.

Human papillomavirus (HPV) is almost always (about 95%) the cause of cervical cancer. HPV is a virus that can be transmitted through sexual contact. There are many types of HPV. Certain types of HPV can cause changes in a woman’s cervix that over time can lead to the development of cervical cancer.

Risk factors

The initiation of sexual activity at an early age. Starting sexual activity at a young age increases the chance of HPV infection.

Multiple sexual partners. The probability of HPV infection increases with the number of sexual partners, and in particular, the greater the number of sexual partners, the greater the risk of HPV infection.

Smoking. Smoking has been associated with an increased risk of cervical cancer.

Weakened immune system. Women with a weakened immune system from another cause or due to chronic medication and HPV infection are at greater risk of developing cervical cancer.

Other sexually transmitted diseases. Sexually transmitted diseases (such as chlamydia infection, gonorrhea, syphilis and HIV/AIDS) increase the risk of HPV infection.

The global strategy to eliminate cervical cancer adopted by the World Health Assembly in 2020 is based on the following pillars: primary prevention through expansion of vaccination against the human papillomavirus (HPV), secondary prevention through screening control and tertiary prevention by providing treatment for all women diagnosed with the disease, worldwide.

The proposed actions include interventions throughout people’s lives.

For children it is recommended:

Vaccination of girls aged 9-14 years against the HPV virus ideally before the start of sexual activity. In our country, the National Immunization Committee recommends vaccination for both sexes from the age of 9.

Informing the population about the health risks of smoking.

Sex education adapted to the age and needs of different populations.

Information and promotion of condom use in the sexually active population.

For women in the general population from the age of 30 and for women with HIV from the age of 25 it is recommended:

Regular screening with highly reliable laboratory tests (HPV DNA test and HPV mRNA) every 5 to 10 years, followed by treatment immediately or as quickly as possible in those diagnosed with HPV.

Women living with HIV should be tested more frequently, every 3 to 5 years.

Regardless of age, in case of invasive cancer it is recommended:

• Surgery
• Radiotherapy
• Chemotherapy
• Palliative care

According to the guidelines of the Hellenic Obstetrics & Gynecology Society:

Cervical cancer screening should begin when a woman turns 21 years of age except in cases of immunocompromised individuals where screening is recommended to begin earlier.

For women aged 21-30, follow-up with cytological examination of a cervical smear (Pap test) is recommended every three years. In the age group over 30, it is recommended to check women every three years with a combination of cytology and HPV DNA testing.

“Cervical cancer can be prevented. No woman should die from this disease.. A future without cervical cancer is in our hands. We have the knowledge and the tools,” emphasizes Dr Nino Berdzuli, director of Country Health Programs at WHO/Europe.

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