Cervical cancer is the 3rd most common cancer among women; know the risks

O cervical cancer also called cervical cancer, is the third most common type of cancer among women in Brazil, excluding cases of non-melanoma skin tumors.

In 2023, more than 17,000 new cases are estimated, a considered risk of 13.25 cases per 100,000 women, according to data from the National Cancer Institute (Inca).

The disease is caused by persistent infection with some types of HPV, the human papillomavirus. HPV infection is common and in most cases does not cause cervical cancer. However, cellular changes can progress to cancer. The preventive exam, known as Papanicolaou, allows the identification of alterations in an early way.

Risks, symptoms and diagnosis and treatment

According to Inca, the early onset of sexual activity, having multiple partners, smoking and prolonged use of contraceptive pills increases the risk of this type of cancer.

Cervical cancer may have no symptoms at an early stage. The disease counts as a slow development and, in the most advanced cases, can progress to vaginal bleeding that comes and goes or after sexual intercourse, abnormal vaginal discharge and abdominal pain associated with urinary or intestinal discomfort.

The diagnosis can be made from different tests, including the Papanicolaou. From the clinical examination, the doctor can evaluate the structures of the vagina, cervix, ovaries and rectum.

Colposcopy, on the other hand, consists of an examination that allows you to visualize the vagina and cervix with a device capable of detecting abnormal lesions. Finally, if abnormal cells are detected, a biopsy may be requested, with the removal of a tissue sample for analysis.

The treatment is defined in a personalized way, considering the characteristics of the tumor and the patient. Procedures include surgery, chemotherapy, and radiation therapy. The type of treatment depends on the evolution of the disease, tumor size and personal issues, such as the patient’s age and the desire to have or not have children in the future.

HPV prevention and vaccine

The prevention of cervical cancer is related to the reduction of the risk of contagion by HPV. The virus is transmitted through sexual intercourse, mainly through microlesions resulting from friction with the mucosa or skin of the genital or anal region.

“The form of prevention is the use of condoms during sexual intercourse, but without a doubt, the greatest impact for disease control is mass vaccination, with the HPV vaccine”, says physician Fernando Zamprogno, coordinator of Meridional Network Clinical Oncology/Kora Saúde.

The immunization is offered by the Unified Health System (SUS) for girls and boys aged 9 to 14 years, in addition to women and men aged 15 to 45 years living with HIV / AIDS, transplanted and cancer patients.

The Ministry of Health recommends that children and adolescents should receive the two-dose vaccination schedule. Adolescents who receive the first dose of this vaccine between 9 and 14 years old can take the second dose even if the six months of the recommended interval are exceeded, so as not to miss the chance of completing the vaccination schedule, according to the folder.

Women and men living with HIV/AIDS, solid organ transplants, bone marrow transplants or cancer patients aged 9 to 45 years receive the three-dose regimen.

About HPV

HPV is the name given to a group of more than 200 types of viruses capable of infecting both the skin and the oral, genital and anal mucosa of women and men.

Depending on the persistence of the infection and, above all, the ability of the virus to lead to the development of cancer, lesions can develop that need to be treated so that they do not evolve into tumors over the years, especially in the cervix, but also in the vagina , vulva, anus, penis, oropharynx and mouth.

Transmission of HPV usually happens through sexual intercourse, whether through vaginal, oral, anal or even during mutual masturbation, without the need for unprotected penetration for contagion.

In addition to vaccination, the use of an internal or external condom during sexual intercourse is recommended for the prevention of HPV and other sexually transmitted infections (STIs).

The virus can be present in the vulva, pubic, perineal, perianal or scrotal area. The condom for internal use is the most effective way to avoid HPV, as it also covers the vulva, but it is recommended from the beginning of sexual intercourse.

In most cases, HPV infection is silent. The virus can remain in the body indefinitely, without showing signs visible to the naked eye or even internal symptoms. In most cases, the immune system itself takes care of fighting the virus before symptoms appear.

Among women, most infections resolve spontaneously by the body itself within an approximate period of up to 24 months. But there are cases in which the virus manages to remain in the body, waiting for a possible drop in immunity to cause the appearance of lesions, according to the ministry.

Genital manifestations of HPV can be discrete, perceived only through specific exams, such as the appearance of warts with cauliflower-like appearance, painless or with mild itching.

The first symptoms can appear from two to eight months after infection with HPV, and it can take 20 years for any sign of infection to appear. Manifestations are usually more common in pregnant women and people with low immunity.

The diagnosis of HPV is currently performed through clinical and laboratory tests, depending on the type of lesion, whether clinical or subclinical. There is no specific treatment to eliminate the virus. Therapy to combat genital warts, for example, must be individualized, depending on the extent, quantity and location of the lesions.