Early detection of cervical lesions with cervical cancer screening

  Early detection of cervical intraepithelial neoplasia and cervical cancer can be achieved through regular screening for cervical cancer.  Many women of childbearing age are told by their doctors during gynecological checkups that they have cervical erosion or cervicitis. The term “cervical erosion” has now been redefined and is no longer a disease.  The surface of the normal cervix is smooth and covered with squamous epithelium. When some of the squamous epithelium is replaced by columnar epithelium, the surface looks as if it is celiac disease, which is now called columnar epithelial migration.  Cervical lesions include cervicitis, cervical intraepithelial neoplasia, and cervical cancer.  Cervical intraepithelial neoplasia (CIN) is a type of cervical precancer that can progress to cervical invasive carcinoma, remain unchanged, or regress spontaneously.  Certain types of cervical lesions have the same local presentation of the cervix as columnar epithelial metastases. Cervical intraepithelial neoplasia usually has no obvious symptoms and signs, and some of them may have manifestations of cervicitis such as increased leucorrhea, leucorrhea with blood, contact bleeding and cervical hypertrophy, congestion, erosion and polyps, so the diagnosis of cervicitis and cervical intraepithelial neoplasia or cervical cancer cannot be differentiated by visual observation.  Cervical intraepithelial neoplasia can lead to cervical cancer if it continues to develop. If cervical intraepithelial neoplasia is detected at an early stage, its progression to cervical invasive cancer can be interrupted by treatments such as LEEP and cold knife surgery.  Nowadays, it is already possible to detect cervical lesions early and treat them in time by performing cervical cancer screening.  Cervical cancer screening methods: 1. Cervical smear cytology (or called cervical liquid-based cytology) and or cervical high-risk HPV virus test 2. Colposcopy 3. Cervical biopsy (cervical biopsy + pathological examination).  These are the 3 steps in the diagnosis of cervical lesions.  Among them, cervical scraping cytology is the main method to detect cervical precancerous lesions. If the first step is normal, the second and third steps are not necessary; if problems are found in the first screening step, colposcopy and cervical biopsy may be needed depending on the results.  Cervical intraepithelial neoplasia can occur for many reasons.  They can include early sexual intercourse, multiple sexual partners, viral infections, smoking, sexually transmitted diseases, oral contraceptives, immunodeficiency, socioeconomic status, etc. They can also be related to the histological characteristics of the cervix itself.  Cervical intraepithelial neoplasia occurs in close association with human papillomavirus (HPV) infection.  There are two types of human papillomavirus (HPV): high-risk and low-risk.  If a woman is infected with high-risk HPV virus, the virus may cause precancerous lesions or cervical cancer in the cervix if her resistance is low and the virus is delayed to be cleared.  How to treat cervical lesions Cervical intraepithelial neoplasia is divided into three grades: grade I, which is mild atypical hyperplasia, grade II, which is moderate atypical hyperplasia, and grade III, which is severe atypical hyperplasia and carcinoma in situ.  Cervical intraepithelial neoplasia grade I can be closely observed and regularly reviewed, and most of them can subside naturally.  Cervical intraepithelial neoplasia grade II, LEEP surgery is feasible.  For cervical intraepithelial neoplasia grade III, cold knife surgery (cervical conectomy) is performed to remove part of the diseased cervical tissue.  Cervical cancer is treated with surgery, radiotherapy, chemotherapy or combination therapy according to the stage.