On January 9, 2013, CCTV News broadcast spent more than 2 minutes to broadcast a health news, releasing the 2012 China Tumor Registry Annual Report, which is the first time that China published the national tumor incidence situation. The content of the news broadcast was like this – about 8 million people worldwide die from cancer every year. The main cancer that seriously threatens the health of our population is lung cancer. Other major tumor deaths in men include liver cancer, stomach cancer, esophageal cancer; other major tumor deaths in women include breast cancer, stomach cancer, liver cancer, etc. The current incidence rate of tumors in China is 285.91/100,000, with an average of 6 people diagnosed with malignant tumors every minute every day. The national tumor incidence is registered and counted by the National Tumor Registry, with data from 72 tumor registries in 24 provinces across China, covering 85 million people. The 2012 China Tumor Registry Annual Report released statistics for 2009. 2012 Zhejiang Province has 6 tumor registries, namely Hangzhou City, Jiaxing City, Jiashan County, Haining City, Shangyu City and Xianju County, and the data registered by these 6 tumor registries are finally aggregated to Zhejiang Cancer Center. The cancer incidence rate in Zhejiang Province is higher than the whole country, and the mortality rate is lower than the whole country. Zhejiang 320.20/100,000: 285.91/100,000 nationwide. However, in terms of mortality, the crude cancer death rate in Zhejiang Province is 176.97/100,000: 180.54/100,000 nationwide. 2009, the top 10 tumors in the registration area in Zhejiang Province in order of incidence are: the first lung cancer (57.63/100,000), the fifth breast cancer (22.94/100,000), and the ninth cervical cancer (9.39/100,000). The top 10 mortality tumors breast cancer ranked (3.49/100,000) 10th. Let’s talk about the most common gynecological malignancy: cervical cancer, and the most important points that people are concerned about: First, how to prevent it? Secondly, how to detect it at an early stage if you are unfortunately shot? Finally, we will briefly talk about its treatment and prognosis. In 2002, the famous actress Li Yuan Yuan passed away at the age of 41 due to advanced cervical cancer, and in 2003, Anita Mui, known as the “Queen of Variety” in Hong Kong show business, died at the age of 40 due to lung dysfunction caused by cervical cancer. She was preceded by her sister Mei Ai Fang. Cervical cancer is the most prevalent malignant tumor in the female reproductive system. When I first joined the workforce, cervical cancer patients were basically middle-aged women or old ladies, and there were fewer young ones. In my second year of work, I personally met two of the youngest cervical cancer patients, one 17 years old and one 19 years old. The pathology after surgery suggested multiple lymph node metastases. The prognosis was poor, and indeed it was, as both recurred within 1 year and were expected to be gone. And our textbook says that cervical cancer occurs in women between 50-60 years old. Then I was wondering why they got this disease at such a young age. At that time, I was a resident, and there was a “marital history” in the medical history. The 17-year-old said, “I’ve had so many, I can’t count them all, and I’ve had three miscarriages. The 19-year-old said: “I have had a boyfriend, has broken up”. The reason is that he has several girlfriends outside. Also had a sex life. I say here that these two cases, what are the characteristics, one is the young age, the second is that they are unmarried, third, either their own life indiscretion, or sexual partner life indiscretion. The first two points lead them to ignore, or not pay attention to, or bad awareness check, missed early detection. Many of those in their 20s are married, and they come to the hospital for regular checkups, so they are detected early. They are very young, unfortunately. Medically, cervical cancer patients younger than 35 years old are called young cervical cancer patients, but in recent years, the number of young women in their 20s and 30s suffering from cervical cancer has increased significantly, and a considerable number of them are already in the middle and late stages when first diagnosed. According to the Beijing Municipal Health Bureau’s statistics on cervical cancer patients in 2009, the incidence of cervical cancer has tripled compared to 10 years ago, with the highest mortality rate in Shanxi and the lowest in Tibet. And about 200,000 women die from cervical cancer every year worldwide. It is written in many books that cervical cancer is most common in middle-aged and older women aged 50-60. So, how can young women suffer from a common disease in middle-aged and older women? The medical histories of the two young girls in the previous section contain several major factors that contribute to the high incidence of cervical cancer: 1. early onset of sexual activity (less than 18 years old, 3.5 times the risk in a study by the Chinese Academy of Medical Sciences in a county in Shanxi); 2. multiple sexual partners; 3. only one sexual partner, but several sexual partners (five times the chance of cervical cancer if there are more than two); 4. multiple pregnancies and births; 5. smoking; and 6. 5. Smoking. 6. genetic mutations, cervical cancer can also originate from the mother. Women in their childbearing years who are stimulated by some physical or chemical factors in their daily life for a long time may have aberrations in their germ cells. Their offspring are often prone to cancer after birth. For example, women who become pregnant while taking certain contraceptives with high progestin content or while using estrogen are more likely to have girls who develop cervical adenocarcinoma later in life than the average woman. However, overall, the rate of adenocarcinoma is much lower than that of squamous carcinoma, so the first four causes are the main ones. According to related studies, the first four factors in fact ultimately boil down to a virus called high-risk HPV virus (also called human papillomavirus). All of the previously mentioned factors increase the chances of the cervix being exposed to this virus or decrease the normal cervical resistance to this virus. What is the HPV virus. And what is high-risk HPV? Condyloma acuminatum, which you may have heard of, is an STD. It may occur on the genitals and, in special cases, on the scalp, mouth, etc. It is also caused by HPV virus, but it is low-risk HPV, so it is good to understand that in addition to low-risk HPV virus, the consequence of high-risk virus infection is that it may lead to cervical precancerous lesions, or even cervical cancer. High-risk HPV viruses include type 16, type 18, etc. Foreign related research shows. About 1/7 of women infected with high-risk HPV virus will have cervical precancerous lesions in their lifetime, and 2% of them will develop into cancer. From HPV infection to cervical precancerous lesions to the development of cervical cancer there is generally a latency period of 8 years, from the prevention and treatment of HPV infection to the treatment of cervical precancerous lesions are enough time, the key is to pay attention. Emphasis, “HPV infection is an important warning of cervical cancer, not all HPV infection will develop into cervical cancer, the real HPV dye develop into cancer only 2% of the risk, but also can not ignore the treatment of HPV infection. Prevention of HPV infection in young women is extremely important to prevent cervical cancer. They should: be clean, avoid premature sexual intercourse, fix sexual partners and abstain from sexual intercourse; use condoms; promote late marriage and family planning to avoid trauma to the cervix; keep the lower body clean; treat chronic gynecological inflammation and pre-cancerous lesions in time; avoid smoking and alcohol, cold and greasy food, etc. In addition, the prevention of cervical cancer is a matter of two people. Early stage of cervical cancer is usually asymptomatic; once symptoms start to appear, the difficulty of cure is greatly increased. One of the most obvious first symptoms is vaginal bleeding. Young patients show contact bleeding, which occurs during sexual intercourse, gynecological examination and bleeding after stool; or there is increased vaginal discharge and it is white or bloody, thin like watery or rice soup-like, with fishy odor. However, although cervical cancer is terrible, it is not completely incurable. With early detection and treatment, the cure rate of early cervical cancer can reach more than 90%, and if treated timely, young women can still retain their fertility. So, how to detect it early? Regular gynecological examination is the key to cervical cancer prevention and treatment, and it is also a “talisman” for women to stay away from cervical cancer. In cervical cancer screening, HPV test and LCT (Liquid-based Thin Layer Cytology) are two types of tests, HPV test can check whether a patient is infected with HPV and its type, while LCT mainly targets cervical intraepithelial neoplasia (CIN), which is a precancerous lesion of cervical cancer. Especially, LCT is the most advanced cervical cancer cytology examination technique internationally, with a detection rate of over 90 for precancerous lesions and cervical cancer cells. Once young women start to have sex, they should have a cervical cytology examination regularly. It is generally advocated that women who have been sexually active for more than 3 years or who are over 20 years old should undergo cytological examination once a year, especially for women with severe cervical erosion, contact bleeding and cervical warts who are at high risk for cervical cancer. The following groups of people should also have regular gynecological cancer examination: those who have sex before the age of 18, frequent and disorderly sex life, multiple childbirth, sexually transmitted diseases, cervical inflammation and erosion, vaginal bleeding after sex, vaginal discharge after menopause, especially bloody discharge, and those over 45 years old without any symptoms should have regular routine examination. At present, our oncology hospital routinely performs HPV test and liquid-based thin layer cytology test for healthy people who come to the hospital for physical examination, as well as those admitted to hospital for uterine fibroids and ovarian benign and malignant tumors. There are often cases that patients with fibroids or ovarian cysts come to the hospital and are ready to undergo subtotal or total uterine excision or cyst debridement or resection, and once the 2 tests are done, they suggest precancerous lesions CINII-III. Then biopsy and cervical conization are done to find an early cancer or cancer in deeper places, and then radical surgery is done. The surgery is more extensive than the fibroid surgery. Those who need it then do follow-up radiotherapy or radiotherapy. After the completion of the piecemeal less spent a month, 40,000 or 50,000 yuan, more spent more than 3 months, nearly 100,000 yuan money, not including the effort and cost of the later review every few months. The patient thanked her for saving her life. But to put it another way, there is really no need to go to that much trouble. If this patient regularly does these two tests once locally, it should be possible to detect HPV infection at the time of precancerous lesions, followed by medication or regular follow-up, so we can only strongly, strongly recommend that every woman who comes in for a checkup has these two tests done as her financial situation allows. If early precancerous lesions are found and the doctor judges that surgery is not allowed, generally the vaginal douche is intensified to dilute the virus and interferon suppositories are used to interfere with the replication of the virus and reduce the number of viruses, so that the two-pronged approach will hopefully result in a negative virus test after a period of treatment. If the number of viruses is reduced, the disease will turn negative or even normal in some patients. However, if it progresses to CINII-III, or if CINII-III is found on the first test, then we will do a minor surgery, a conical hysterectomy. If the cut surgical margins are negative, you will be reviewed regularly and continue to check those two tests. Only if several consecutive viral tests are negative, can we return to regular annual checkups. This minor surgery done well can avoid major surgery and can preserve fertility, but there are also sequelae such as increased miscarriage rates and cervical atresia. So it is still the same, it is better to have routine physical examination and better to detect early. If there is invasive cancer, radical cervical cancer surgery will be required. If there is deep muscle layer or deep interstitial infiltration, positive cutting edge, vascular tumor embolism, lymph node metastasis, etc., then postoperative radiotherapy is needed. The prognosis would be worse that way.