Cervical cancer is the most common gynecological malignancy, second only to breast cancer. It is reported that about 75,000 women newly develop cervical cancer every year in China. Thankfully, cervical cancer is the only cancer among all cancers with a clear etiology, i.e. human papillomavirus (HPV) infection is the main cause of cervical cancer. Many women are afraid of gynecological checkups, thinking that a yearly ultrasound of the uterine adnexa is all that is needed. In fact, gynecological examination can only visualize the appearance of the cervix. Some patients think that it is endocrine disorders because of vaginal bleeding without lumps in ultrasound examination and treat it according to menstrual disorders, but finally gynecological examination finds that it is cervical cancer, which is regrettably at this time most of the patients have already in the middle and late stages, and they have missed the optimal time for treatment, which is very unfortunate. Ultrasonography can find out the thickness of the endometrium, whether there are masses in the uterine cavity, such as polyps, fibroids, or even endometrial cancer, as well as whether there are masses in the ovaries, etc. However, ultrasonography is unable to see the cellular changes in the cervix, and it is even more impossible to find out the pre-cancerous lesions. As a matter of fact, cervical cancer is very preventable. As long as you choose the right test, you can kill more than 90% of cervical cancers at the stage of “precancerous lesions”. Risk factors related to cervical cancer 1. HPV infection: High-risk HPV infection is found in about 90% of CIN and more than 99% of cervical cancer tissues, of which about 70% are related to HPV types 16 and 18. Twenty percent of those with high-risk HPV infection will remain infected, and 3.2 percent of them will eventually turn into cervical cancer. 2.Multiple sexual partners, early sexual intercourse (<16y), young age at delivery, high number of deliveries, sexually transmitted diseases. 3.Smoking: can increase the effect of HPV infection. 4.Economic factors: poor economic conditions, poor hygiene habits. Immunity factors: poor resistance, low immunity, easy to be infected with HPV. Three-level prevention and control of cervical cancer Cervical cancer vaccination belongs to the first level of prevention and control (treating the disease before it occurs), while screening belongs to the second level of prevention and control (treating the first disease), and the diagnosis and treatment of cervical cancer belongs to the third level of prevention and control (treating the disease after it occurs). At present, China has introduced preventive HPV vaccines for women to prevent precancerous lesions and cancers of the cervix, vulva, vagina and anus caused by high-risk HPV infections: bivalent vaccine, targeting HPV16 and HPV18 (related to cervical cancer and precancerous lesions); tetravalent vaccine, targeting HPV16, 18, 6, and 11 (related to genital warts of anus); septavalent vaccine, targeting HPV16, 18, 6, and 11 (related to genital warts of anus); and septavalent vaccine, targeting cervical cancer (related to genital warts of anus). Quadrivalent vaccine, targeting HPV types 16, 18, 6 and 11 (related to anogenital warts); Nine-valent vaccine, targeting HPV types 31, 33, 45 and 52 (related to cervical cancer and precancerous lesions) in addition to HPV types 16, 18, 6 and 11. 2. Secondary prevention and control: Screening (TCT+HPV) Early detection and treatment of precancerous lesions of the cervix is possible. Because precancerous lesions of the cervix and early stage have no clinical symptoms, most of them are already in the middle or late stage when symptoms appear. The detection rate of pre-cancerous cervical lesions can be more than 90% with the combination of cervical TCT and HPV. When should I start screening? Any woman who is sexually active is at risk for cervical cancer. It is recommended that routine screening for cervical cancer with TCT (liquid-based cytology) and HPV (human papillomavirus) should be done from the age of 25 (or from the time of sexual intercourse) to the age of 65. If both TCT and HPV are normal, they can be checked every five years until age 30 and reviewed at least every three years after age 30 until age 65. Precancerous lesions: cervical intraepithelial neoplasia (CIN) Cervical cancer progresses slowly, with 5 to 10 years to progress from precancerous lesions to malignant invasive cancer. CIN is a group of precancerous lesions closely related to invasive carcinoma of the cervix, which reflects the successive processes in the development of cervical cancer. It is categorized into CINⅠ, CINⅡ and CINⅢ. About 60% of CINⅠ will subside naturally and can continue to be observed; about 20% of CINⅡ will develop into CINⅢ, and 5% will develop into invasive carcinoma.LEEP knife treatment is the main treatment for CINⅡ and CINⅢ, which is simple, rapid and does not require hospitalization. Symptoms of Cervical Cancer Usually there are no symptoms of early cervical cancer or precancerous lesions. The initial symptom of cervical cancer can be increased vaginal discharge, which is white or blood-colored, thin like water or rice soup, with fishy smell. In some cases, irregular vaginal bleeding occurs, which is mainly manifested as: non-menstrual vaginal bleeding; contact bleeding: bleeding or pain during sex; postmenopausal vaginal bleeding. Late stage symptoms mainly include: discharge of unpleasant vaginal discharge. As the cancer involves the neuro-skeletal and urinary systems, pelvic pain, back pain, bleeding or pain during urination can occur. Further development of the cancer involving the lymphatic system and the whole body can result in lower limb edema, fatigue and wasting. HPV vaccination, regular cervical cancer screening, paying attention to personal hygiene and sexual knowledge, and strengthening physical fitness can prevent more than 90% of cervical cancer. If irregular vaginal bleeding, bleeding after coitus, or bleeding after menopause occurs, you should consult a doctor promptly to rule out cervical cancer. Early detection and early treatment can get good results.