Among cervical diseases, the most worrying disease is cervical cancer. The reason is that most people do not know enough about cancer nowadays, they talk about cancer and think that cancer is incurable and will surely die. In fact, there are many types of cancer, which can occur in almost all parts of the human body, so to speak, cancer can grow in any part of human body except hair and nails. Among the gynecological malignant tumors, the most common are cervical cancer, endometrial cancer and ovarian cancer. Among these three malignant tumors, cervical cancer and endometrial cancer can now be detected, diagnosed and treated early by most patients. Only ovarian cancer is asymptomatic in the early stage, and most of the patients are already in the late stage when they are found, with a poor prognosis and a 5-year survival rate of less than 50%. Cervical cancer is one of the most common gynecological malignant tumors, and it is the second most common malignant tumor among women after breast cancer. There are 4.61 million new cases of cervical cancer and more than 200,000 deaths each year worldwide. Cervical cancer occurs with significant geographical differences. The highest incidence is in developing countries, especially in Asia, South America and parts of Africa. The lowest is in Australia, New Zealand, Southern Europe, and North America. The distribution of cervical cancer in China is mainly in the central region, regardless of the distribution in provinces, cities and counties, there is a gathering phenomenon, rural areas are higher than urban areas, mountainous areas are higher than plains, the geographical distribution reflects that the incidence of cervical cancer is related to economic development. Nowadays, cervical cytology examination is commonly used in China, so that cervical cancer and precancerous lesions can be detected and treated at an early stage, and the incidence of cervical cancer has dropped significantly. The mortality rate has also been decreasing. 2. Nowadays, many lesbians are found to have cervical erosion during physical examination, will cervical erosion develop into cervical cancer? Here I would like to correct a concept that cervical erosion and cervical cancer are two different concepts. There are many causes of cervical erosion, such as endocrine, mechanical factors, chemical factors and so on. In most cases it is an inflammatory change. By itself, it has nothing to do with cervical cancer. Heavy cervical erosion is not necessarily cervical cancer, and it is possible for a gay man without cervical erosion to have cervical cancer. However, cervical erosion is not easily distinguished from early cervical cancer during gynecological checkups, which requires regular health checkups. The cause of cervical cancer is clear: human papilloma virus viral infection. It is an infectious disease and without papillomavirus infection you will not develop cervical cancer. If we can prevent HPV infection, we can say that we can prevent cervical cancer; if we don’t have HPV infection, we can say that we won’t get cervical cancer. This is a definite conclusion, which was recognized in the International Gynecologic Oncology Conference. In this sense cervical cancer may become the first cancer to be eradicated on earth. HPV is the main or basic cause of cervical lesions. More than 110 types of HPV have been identified in the world, about 35 types are involved in reproductive tract infections and about 20 types are associated with tumors. Depending on the type of HPV
The risk of cancer is divided into two types: high-risk and low-risk. From the perspective of infection, it can be divided into latent infection, subclinical infection, clinical symptoms and HPV-associated tumor stage. In terms of regression, it can be divided into clear infection, transient infection (or virus carriage), and persistent infection. HPV infection is more common, especially during the sexually active period before age 30 (instrumental contraception is advocated). Most HPV infections can be cleared and are “transient” infections that do not lead to CIN, but an HPV infection that is not cleared may have a 5% chance of developing into CIN after about six months. Generally speaking, within one year, 70% of HPV infections are cleared, and if two years pass, about 90% are cleared. In other words, most HPV infections can be cleared in one or two years, 6 to 24 months, and if they are not cleared, they may develop into a different grade of CIN. an HPV infection may have a low-grade LSIL if less than one year has passed, and if it is not cleared after more than one year, it may develop into a higher grade of intraepithelial neoplasia. So these figures tell us the concept that HPV can be cleared in six months to more than a year, and if not, they may develop into different levels of intraepithelial neoplasia, or CIN, which is a process of subclinical symptoms, subclinical stage, a clinical infection stage, and develop into a precancerous lesion, or cervical cancer. To correctly understand and treat HPV infection, it is now clear that no HPV infection = no cervical cancer, but HPV infection ≠ getting cervical cancer. Only a few persistent, high-risk types will cause CIN and CC, while low-risk types rarely cause lesions. HPV(+) is an indication of an infection, and the chance of CC risk is only 2%. From HPV
CIN
CC takes quite a long time, usually 8-10 years. Avoiding HPV infection can prevent the occurrence of cervical cancer. Treating cervical lesions caused by HPV infection is treating HPV infection, which is an important cancer prevention measure. It is inappropriate to take HPV infection examination and treatment lightly and to have excessive fear of HPV infection. 5.Cervical pre-cancerous lesions, cervical intraepithelial neoplasia Cervical intraepithelial neoplasia (CIN), or call it cervical precancerous lesions (PDC). It includes cervical atypical hyperplasia and cervical carcinoma in situ, and is also divided into CIN I, CIN II and CIN III, reflecting the evolution of cervical carcinogenesis. Usually, most cervical intraepithelial lesions, develop slowly and with some progressiveness, or even fade or are reversible. From CIN I
CIN II CIN III
CC, it takes several years, or more than 10 years. The higher the CIN grade, the lower the chance of regression and reversal. The higher the grade of CIN, the smaller the chance of regression and reversal, and the risk of developing CC is 4 times, 14.5 times and 46.5 times higher than normal for CIN I, CIN II and CIN III, respectively. 6. How to diagnose and detect cervical intraepithelial neoplasia Rely on a three-step technique, first step: cytological primary screening, with papillomavirus testing if available, second step: colposcopy for a comprehensive assessment of the lesion site, and third step: tissue biopsy to determine the diagnosis and treatment. HPV testing with cytology HPV+ Cytology+