Three lines of defense against cervical cancer
Cervical cancer is a malignant tumor that occurs in the female cervix and is one of the most common malignant tumors, with the second highest incidence rate among female tumors. There are 500,000 new cases and about 200,000 women die from this disease worldwide every year. Globally, the high incidence of cervical cancer is mainly in developing countries, and the distribution of cervical cancer in China is mainly in the central and western regions, with a general trend of higher incidence in rural areas than in cities, and higher incidence in mountainous areas than in plains; Shaanxi, Gansu, Shanxi, Inner Mongolia, Jiangxi and other provinces are the high incidence areas of cervical cancer in China. The high incidence age of cervical cancer is mostly after 35 years old, and the peak age is 45-59 years old, but the incidence has shown a younger trend in the past 10 years, and the proportion of cervical cancer before 35 years old has increased significantly.
What are the causes of cervical cancer? A great deal of research has been done on this issue, but the one who really found the problem is Harald K. Chur, the 2008 Nobel Laureate in Medicine. Trull? Hausen, whose research showed that HPV (human papillomavirus) infection is a necessary factor in the development of cervical intraepithelial neoplasia and cervical cancer, the “culprit” of cervical cancer. There are more than 200 types of HPV, which are artificially divided into high-risk types and low-risk types. Cervical lesions can be detected early, diagnosed and treated early to avoid the occurrence of cervical cancer.
The first line of defense: early prevention HPV vaccination After decades-long clinical research and development, the preventive cervical cancer vaccine was marketed in the United States in 2006, and the birth of HPV vaccine brought good news to many women worldwide. Subsequently, the vaccine has been approved for use in more than 100 countries worldwide. The HPV vaccine for women in China is also under intensive development and will be available soon.
The HPV vaccine is the first cancer vaccine in human history, making cervical cancer the first malignancy to be prevented and eliminated through vaccination, screening and early diagnosis and treatment. There are currently two human papillomavirus (HPV) vaccines available worldwide: quadrivalent Gardasil, developed by Merck, and bivalent Cervarix, from GlaxoSmithKline GSK. Gardasil protects against HPV types: 6, 11, 16, and 18. Both Gardasil and Cervarix have been found to be effective in preventing HPV infection only when administered prior to the onset of HPV infection, and are therefore recommended prior to the onset of sexual intercourse. The FDA approved Gardasil for women aged 9-26 years and Cervarix for women aged 10-25 years.
The introduction of the HPV vaccine has ushered in a new era in the prevention and treatment of cervical cancer, establishing the first line of defense against cervical cancer.
Second line of defense: early detection Standardized CIN treatment Many developed countries have effectively explored new ideas of comprehensive cervical cancer prevention and treatment based on strengthening traditional screening measures in combination with vaccination.
For cervical cancer in China, screening programs have also been developed to suit different regions and economic conditions in China, including primary programs (visual observation + iodine test), general programs (high-risk HPV test + Pap smear) and optimal programs (high-risk HPV test + cervical TCT test). Screening should start at age 21; screening should be performed every 2 years for those aged 21-30 years; screening can be performed every 3 years for those aged ≥30 years if 3 consecutive screening results are negative; screening can be stopped for those aged 65-70 years if 3 consecutive screening results are negative and no abnormal results have been obtained in the last 10 years.
For those with abnormal screening results, a three-step cervical lesion diagnosis is performed
Three-step ladder
3Histopathological examination
2 Colposcopy
(final confirmation of diagnosis)
1.Cytological examination
(biopsy under direct vision + ECC)
Pap or TCT (primary screening)
CIN is cervical intraepithelial neoplasia, which is a precancerous lesion of the cervix. According to the pathological results, symptomatic local treatment: physical therapy, nowadays LEEP therapy, which is widely used in clinical practice, can block the lesion before the occurrence of infiltrative cancer.
The third line of defense: rational face scientific treatment If the first two lines of defense are lost and unfortunately diagnosed with cervical cancer, first of all, it must be clear: cancer ≠ death, and going to regular specialized hospitals is the rational way to treat it. Doctors will adopt various means such as surgery, radiotherapy, chemotherapy and traditional Chinese medicine for personalized and comprehensive treatment according to different clinical stages of lesions.
The development of medical technology is rapid, with the adoption of new instruments and equipment, and surgical methods have also improved greatly in terms of emphasizing minimally invasive and preserving organ functions: levy on young patients, surgery to preserve fertility can be adopted, treating the disease and preserving the uterus at the same time. Radiotherapy techniques have also made great strides in treating the disease and mitigating damage to normal tissues. This has greatly improved the survival rate and quality of life of patients.
Vaccination, enhanced screening measures and effective exploration of new ideas for integrated cervical cancer prevention and treatment are the successful experiences of many developed countries in cervical cancer prevention and treatment. We should make full use of the three lines of defense for cervical cancer, care for women’s health, eliminate the killers that endanger women’s health, and make cervical cancer the first malignant tumor prevented and eliminated by humans through vaccination, screening and early diagnosis and treatment.