Cervical cancer is a common malignant tumor that seriously threatens women’s health. In China, cervical cancer is one of the three most prevalent cancers in women, second only to breast cancer, and the second most prevalent among gynecological tumors. According to statistics, there are about 460,000 new cases of cervical cancer worldwide each year, 80% of which occur in developing countries. The number of new cases in China is 130,000 every year, which is nearly 1/3 of the global total, and most of them are in the middle and late stages. 53,000 people die from cervical cancer in China every year.
At what age does cervical cancer mainly occur?
Cervical cancer is the only malignant tumor with a clear cause so far, which is mainly caused by human papilloma virus (HPV) infection. However, HPV infection can cause not only cervical cancer, but also anal cancer, vaginal cancer and cancers of the head, neck and throat are closely related to HPV infection. Although most cervical cancers are related to HPV infection, it does not mean that HPV infection will definitely develop into cervical cancer. 50% to 90% of HPV infections can be cleared by the immune system within a few months to 2 years after infection and will not lead to long-term harm. HPV has more than 100 subtypes in total and is divided into high-risk and low-risk types, and only persistent infection with high-risk HPV can progress to malignant lesions. HPV infection is an important causative factor for cervical cancer, but not the only one.
It mainly occurs in the age group between 35 and 50 years old, with the peak at 40-45 years old. However, it does not mean that it is absent after the age of 50, only that the peak age group faces more social impact, so more attention will be paid to women in this age group. Cervical cancer is a slow development process, so some older women should not feel that they can rest easy after menopause, but should still insist on regular gynecological checkups, and only if this checkup is HPV negative and cytology is clean can they have gynecological checkups every 2~3 years. And after reaching 65 years old, in principle, screening can be stopped.
What are the symptoms of precursor cervical cancer? And how to prevent it?
For older women, the main feature of the precursor is postmenopausal bleeding, which can also be manifested as vaginal discharge, running water, back pain and stomach pain. If left unattended, it is likely to be delayed to advanced stage.
To prevent cervical cancer, there are “three early stages”: early screening, early diagnosis and early treatment. In prevention, we mainly rely on screening and raise awareness of screening. The main screening methods are thin layer liquid-based cytology (TCT) and human papillomavirus (HPV) testing. As for the appearance of advanced cervical cancer, it is entirely a matter of personal awareness. The older women are, the more they are not aware of screening, and once cervical cancer is detected, most of them tend to be in advanced stages.
Regarding the prevention and screening of cervical cancer, the Party and the government have invested a lot in this area, but many people still do not pay attention to it, especially in some rural areas where many women do not have a checkup even once every few years. The first is that citizens should pay attention to cervical cancer screening, and the second is that medical professionals should pay attention to opportunistic and curative screening when receiving patients, for example, doctors should ask patients if they have not had a gynecological examination for several years, and if they have back pain or stomach pain, and if they encounter such patients, they can suggest a cervical cancer screening at the same time.
What exactly is the cervical cancer vaccine? What types are there?
What we call cervical cancer vaccine should be called HPV vaccine in the strict sense. The GlaxoSmithKline (GSK) bivalent vaccine, which has recently been launched in the Mainland, mainly targets HPV 16 and 18, which are high-risk cancer-causing viruses, and therefore the bivalent vaccine can prevent 70% of cervical cancers. The quadrivalent vaccine adds HPV6 and 11 to the bivalent vaccine, which are low-risk types of viruses that mainly cause condyloma acuminata, and the nine-valent vaccine includes even more. This is not to say that the high-priced vaccine is better than the low-priced one, but it covers several more HPV subtypes, but these subtypes are not high-risk and are not related to cervical cancer.
There are three doses of HPV bivalent vaccine, one month between the second and the first dose, and six months between the third and the second dose.
Comparison of three types of HPV vaccines
I heard that there is an age limit for HPV vaccination, is it still effective for people who are over this age?
Although it is said that the best age for HPV vaccination is 9 to 25 years old, I believe that the age limit is not absolute and the following three types of people can still be vaccinated.
1, even if you are over 25 years old, as long as you do not have sex, the vaccination is still effective, unless you plan not to have sex for the rest of your life, you do not need to vaccinate.
2, the original HPV infection or HPV infection is unclear, after screening is negative, can also be vaccinated.
The HPV infection caused by the cervical lesions, after treatment, the cervical lesions recede, this kind of vaccination is also possible. As for those who are positive for HPV, vaccination is not recommended. We should know that the HPV vaccine can only play a preventive role and has no therapeutic effect on the already infected virus.
Is it necessary to get vaccinated? Are there any side effects? Where can I get vaccinated?
In my opinion, it is very necessary to get vaccinated. It is also necessary for me, as a doctor and a parent of a child, to urge my child to get vaccinated. I know that many parents have concerns that there may be a risk of disease with the vaccine, but in fact, the HPV vaccine is very safe. Unlike other vaccines, the HPV vaccine is a protein particle of the virus, there is no viral RNA column, and it passively produces antibodies after vaccination, so there are basically no side effects, and occasional reactions such as fever and joint pain are rare. As early as ten years ago, HPV vaccine was already available abroad. Previously, HPV vaccination required a trip abroad or to Hong Kong, which was also more expensive. Now, the vaccine has arrived at your doorstep, and vaccination is available at epidemic prevention stations and community medical services, and the quality is exactly the same as abroad and in Hong Kong, so people who are still on the fence don’t need to have too many worries.
It is important to note that this vaccine is designed with very few virus subtypes, and there are many viruses that are not included, so even if you are vaccinated, it is not a sure thing, and the screening that should be done should still be done.
Is there anything I should pay attention to once I am screened for cervical cancer?
1. Don’t be afraid of cancer and pay attention to the psychological adjustment. The five-year survival rate of cervical cancer detected at an early stage is over 90% after treatment, so don’t leave yourself with psychological burden.
2. Once diagnosed with cervical cancer, you should go to a regular hospital to receive regular treatment, especially to seek treatment from gynecological oncology experts. There is still a difference between general gynecology and gynecological oncology, and gynecological oncology experts have more clinical experience in treating cervical cancer.