From cervical erosion to cervical cancer prevention

  1.How to recognize cervical erosion
  Celiac disease has a high incidence, accounting for 70-80% of women who are sexually active. Many women lack a proper understanding of celiac disease and consider it to be serious, or even associate it with the occurrence of cervical cancer when they have it. Celiac disease is a normal physiological phenomenon, not a disease. The 7th edition of the Obstetrics and Gynecology textbook replaces the term ‘cervical erosion’, with the physiological phenomenon of ‘cervical columnar epithelial ectasia’. The epithelium on the surface of the female cervix has two types during embryogenesis i.e. primitive squamous epithelium and columnar epithelium. The squamous epithelium is multi-layered, some seven or eight layers, some more than ten layers, and looks smooth; the columnar epithelium is single-layered, thinner, and the blood vessels under the epithelium can be seen through the epithelium, they are like strawberries squeezed together, which is also a physiological structure. Normally the columnar epithelium is mostly located in the cervical canal and cannot be seen by the naked eye. However, under the action of estrogen, such as during puberty, the volume of the cervix grows rapidly, exposing the cervical columnar epithelium to the ectocervix and forming a red, rough ectopic cervical columnar epithelium. This is not really ‘erosion’ but a normal ‘stress’ reaction that occurs when there is a hormonal surge in a woman’s body. However, the columnar epithelium is thin and can easily be infected with various microorganisms which can cause cervicitis and form true celiac disease.
  2. Recognize the threat of cervical cancer and precancerous lesions to women
  Cervical cancer is a common malignant tumor of female reproductive system. It ranks second among malignant tumors in women
  High-risk HPV infection is the main cause of cervical precancerous lesions (CIN) and cervical cancer
  The following set of data is sufficient to illustrate how threatening cervical cancer is to women
  High-risk HPV-DNA can be detected in more than 97% of cervical cancer tissues
  Cervical cancer is the second most common gynecologic malignancy.
  There are 50,0000 new cases worldwide each year.
  In addition, there are 1000,0000 high grade precancerous lesions.
  Low-grade precancerous lesions are 3000,0000.
  China accounts for 1/5 of the new cases in the world each year, about 10,000,000.
  About 10,0000.
  3,000,000 people die from cervical cancer.
  From the National Cancer Institute and Qiao Youlin, Beijing Academy of Medical Sciences, 2009, Medical Research
  Famous actors Mei Yanfang and Jiang Qing had cervical cancer
  Although the incidence of cervical cancer is high and scary, cervical cancer can be prevented. If screening is done carefully, cervical cancer can be eliminated, so prevention of cervical cancer is very important.
  3. What are the main causes of cervical cancer, the development process and characteristics of cervical cancer and how to prevent cervical cancer?
  (1) Causes of cervical cancer
  In 2008, a German medical scientist, Harald K. Chur? Trull? Hausen was awarded the Nobel Prize in Physiology and Medicine for his discovery that papillomavirus infection is the cause of cervical cancer. This led to a fundamental shift in the understanding of cervical cancer.
  High-risk HPV includes more than ten types; HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 and other types of HPV16 and 18 have the highest infection rate, and among all types detected, HPV16 accounts for 50%, HPV18 for 14%, HPV45 for 8%, HPV31 for 5%, and other types of HPV for 23%. HPV type was associated with the pathological type of cervical cancer, with HPV16 predominating in cervical squamous epithelial cell carcinoma (51% of squamous epithelial cell carcinoma specimens) and HPV18 predominating in cervical glandular epithelial cell carcinoma (56% of glandular epithelial cell carcinoma specimens) and cervical adenosquamous cell carcinoma (39% of adenosquamous cell carcinoma specimens).
  Cervical cancer does not occur shortly after high-risk HPV infection, and the latency period varies from 2 to 10 years or more.
  (2) The process of cervical cancer: cervical cancer occurs through the slow and long process of cervical precancerous lesions, which can take several years to develop: including cervical precancerous lesions grade I, II and III. Therefore, cervical cancer can be eliminated by regular screening, which is the biggest difference between cervical cancer and other cancers.
  (3) How to prevent the occurrence of cervical cancer
  (1) Pay attention to sexual hygiene: Most studies have shown that the number of recent sexual partners, frequency of sexual intercourse, and the presence of genital warts in sexual partners are closely related to HPV infection. Although some studies have shown that age at first intercourse is also associated with HPV infection, this factor is influenced by the number of sexual partners, and the risk is not significant after adjusting the number of sexual partners.
  ② Enhancement of immunity: The immunity of the host plays a large role in the progression of HPV infection and lesions. One study found that the rate of HPV infection in immunosuppressed people with kidney transplants was 17 times higher than in the normal population. the rate of HPV infection was also increased in HIV-infected people. HPV infection is increased in HIV-infected populations due to factors such as more chaotic sexual behavior, higher number of partners, and younger age at first intercourse. However, some studies do not prove a direct correlation between immunosuppression and HPV infection. The HPV infection rate may be increased in the HIV population due to the high risk of self-exposure or the reduced ability of the body to resist latent viruses, and the HPV DNA detection level in this population is higher than in the normal population, which indicates a reduced ability of the body to suppress HPV infection.
  ③ Annual cervical cytology examination (cervical smear or TCT): more than 90% of precancerous lesions can be screened, but non %, for specific types of cervical precancerous lesions cannot be detected.
  ④ Therefore, high-risk HPV screening is advocated for women over 30 years of age: for screening of high-risk HPV infection the HC-II method is currently used internationally in a uniform manner.   The sensitivity is greater than that of cervical cytology screening, and the screening rate for precancerous cervical lesions can reach almost 100%.
  ⑤ Colposcopy can be performed in a timely manner to confirm the diagnosis and timely treatment of abnormal cervical cytology and positive high-risk HPV to prevent the occurrence of cervical cancer.

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