LivingWhy not going to the gynecologist can kill you?

Why not going to the gynecologist can kill you?

From quite young (around sixteen or after first intercourse) to old age, a gynecological exam should become a regular part of every woman’s life. With the help of diagnostic procedures, the gynecologist determines the health of the female genital tract. It takes care of your reproductive health, from the first period, through pregnancy, to menopause and beyond.

If a woman is planning a pregnancy, has hormonal changes, notices irregular bleeding or discharge, it is necessary to contact a doctor in time. Health professionals will give you the appropriate advice and do the necessary tests.

The gynecological examination is not painful, but it is advisable to relax as much as possible (as much as possible in the uncomfortable situation). Women should be calm so that the examination is carried out more quickly and, at least, not so unpleasantly.

The high mortality of cervical cancer.

One of the reasons for the high mortality of this disease is the fact that in the first phase , this disease is mostly without symptoms , or they are non-specific. So almost 2/3 of women go to the gynecologist for the first time when the disease has already set in. Then the treatment itself becomes difficult and uncertain. In addition to surgery, the use of aggressive radiotherapy is required, which leads to a significant prolongation of treatment and various complications. All this considerably increases the costs and reduces the chances of healing.

What is cervical cancer? And… can it be prevented?

Cervical cancer is a malignant tumor, located in the lower part of the uterus , in front of the vagina. It occurs when some cells in the cervix change and begin to multiply out of control.

Symptoms that should not be ignored , and that delay examination by a doctor, are any extraordinary bleeding (between cycles, after sexual intercourse, after menopause), swelling of the legs and pain in the lower part of the back, increased secretion that lasts a long time, damage to the cervical mucosa.

Any of these symptoms is a potential sign that something may be wrong. However, it is important not to panic, mainly because not all changes are cancer, but we must check what it is.

What are the risk factors for cervical cancer?

The main risk factor is long-term infection with certain types of human papillomavirus (HPV).

There are more than 100 types of HPV , of which about 40 cause infections of the genital mucosa in both sexes. Some of them cause changes in the superficial cells of the cervix, from which cervical cancer can develop over time.

In 99.7% of cervical cancer cases there is an HPV infection. In up to 70% of cases, the cause is one of the high-risk HPV types (16 and 18), which have been shown to be oncogenic!

Since the main risk factor for cervical cancer is long-term infection with certain types of human papillomavirus (HPV), it is considered that the most effective primary prevention measure against this disease is timely immunization against the virus. of the human papilloma.

However, it is very important to note that immunization, however safe and effective it may be as a preventive measure, does not preclude the need for periodic preventive examinations. This is because, although the vaccine covers the most oncogenic serotypes, it does not cover all of them. And there are differences between different vaccines, and in different autonomous communities. In short, it confers protection and is important, but not absolutely so.

HPV infection is a necessary but not sufficient risk factor for cervical cancer. Yet there are other important factors that increase the risk. Early sexual intercourse (before the age of sixteen), long-term use of birth control pills, and multiple sexual partners increase the risk of the disease. Smokers and obese women are also the target group. The risk increases if there is frequent inflammation of the uterus. A weakened immune system (immunosuppressive therapy or HIV) and, of course, irregular check-ups increase the probability of abnormal cell formation.

What is early detection of cervical cancer?

Changes in the cervix caused by a long-standing viral infection (HPV is a virus, after all) take several years to turn into cancer. Regular check-ups aim to detect changes in the cervix early , before cancer occurs, when they can be easily removed. To this end, many countries have launched an organized screening program for early detection of cervical cancer, which should be free for all adult women.

Cervical cancer screening is done with a simple Pap smear.

How is the Pap test performed?

During a brief, painless gynecological exam, a sample is taken from the surface of the cervix. It is analyzed in a laboratory under a microscope, looking for altered cells. During menstruation, the test is not performed. You should not have intercourse two days before, and you should not use any vaginal pills. Cytology is performed first for two years in a row, and then, if the previous two results were regular, every three years.

What happens when the result arrives?

Normally, you collect the test result at your health center. There are services where they call you to inform you of the result. Most women who come for regular checkups have a normal Pap smear. In that case, the risk of getting cervical cancer is very low.

Some women have an abnormal Pap test result. This does not mean that they have cancer, but rather that altered cells have been found in their smear, so additional tests are necessary as directed by the gynecologist. If these tests reveal any alterations, they must be removed. Otherwise, they can turn into cancer.

Simple treatment performed in an outpatient clinic is usually sufficient. These treatments rarely affect a woman’s sex life or her ability to have children.

How to reduce the risk of cervical cancer?

Without a doubt, this is something you can achieve. One of the ways is to go to preventive examinations and periodic check-ups. You can also attend organized check-ups to detect cervical cancer. Find out about the initial symptoms of this disease and go to the doctor if you notice any of them. You can consider HPV vaccination if you belong to the target group to receive the vaccine.

The goal of regular preventive examinations is to detect early changes in the cervix before malignant disease develops. The earlier changes are detected, the easier and more successful treatment will be. When the cancer has already developed, treatment is more difficult. Therefore, its success is less guaranteed.

Remember that in the early stages of the disease there are usually no symptoms!

References:

American Cancer Society Guidelines for the Early Detection of Cancer (2022, 14 de Marzo). Cancer.org. https://www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html

Centers for Disease Control and Prevention (CDC) (2012). Human papillomavirus-associated cancers – United States, 2004-2008. MMWR. Morbidity and mortality weekly report, 61, 258–261. https://pubmed.ncbi.nlm.nih.gov/22513527/

‌Cervical cancer: Risks and causes (2020, 26 de Mayo). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/cervical-cancer/risks-causes

Drolet, M., et al. (2015, 3 de Marzo). Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis. The Lancet. Infectious disease, 15(5), 565–80. https://doi.org/10.1016/S1473-3099(14)71073-4

Felman, A. (2019, 25 de Junio). What is cervical cancer screening? Medical News Today. https://www.medicalnewstoday.com/articles/254577

Freepik(s.f.). Still life fertility concept top view Free Photo [Imagen]. Freepik. https://www.freepik.com/freepik

Richards, L. (2022, 24 de Febrero). 5 ways to prevent cervical cancer. Medical News Today. https://www.medicalnewstoday.com/articles/cervical-cancer-prevention

Smith, L. (2021, 29 de Septiembre). Everything you need to know about the Pap smear. Medical News Today. https://www.medicalnewstoday.com/articles/everything-you-need-to-know-about-the-pap-smear

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