Cervical cancer
Every year, around 350 women in Flanders are diagnosed with cervical cancer. About a hundred women die from the disease every year. However, cervical cancer is a slow-growing cancer that is almost completely curable if detected early. Such an investigation is painless and quite simple. So it is in your best interest not to postpone it.
The uterus consists of two parts: the uterine body and the cervix. The ovaries with the fallopian tubes are located on both sides. The cervix is the narrow lower part of the uterus that connects the uterine body to the vagina. Cervical cancer usually arises from cells in the mucous membrane of the transition between the cervix and cervix.
Origination
The virus HPV or Human Papilloma Virus is usually the cause of cervical cancer.
That virus is transmitted through sexual contact . More than a hundred different types of the virus are known. They fall into three major groups :
- those that infect the skin and cause warts on the skin;
- those that infect the mucous membranes and can cause warts there;
- these that infect the mucous membranes and can lead to cervical cancer. It is mainly HPV types 16, 18, 31, 33 and 45 that are considered the most malignant for the development of cervical cancer.
About 80 to 85% of women come into contact with the virus at some point. Those who become infected with the virus usually do not suffer from it because the immune system reacts against it by producing antibodies.
If this does not happen, you will remain infected with the virus and it can cause changes to the cells of your cervix. These so-called precursor cells show a number of abnormalities compared to healthy cells, but are still harmless. By removing these cells, the doctor can prevent the development of cancer.
Evolution
Several years elapse between the viral infection and the precancerous stage of cervical cancer. The precursor cells develop very slowly into cancer. It takes at least ten years after the infection for cancer to develop.
At first there are no symptoms . That is why actively detecting abnormal cells is important. Over time, you may experience unusual or bloody discharge or actual bleeding between periods or after sex. However, there may also be other causes behind this.
Frequently Asked Questions
- In Belgium, one woman in a hundred will develop cervical cancer before the age of 75. Women between the ages of 30 and 50 are most at risk.
- Women from lower socio-economic groups die from the disease three times more often than other women.
- Women whose HPV infection persists for a long time are at greater risk of developing malignant cells.
- Women who smoke have an increased risk because smoking negatively affects the immune system, which makes clearing the virus more difficult.
- Other risk factors include:
- sexual relations at a young age (before 16 years);
- multiple sexual partners without using a condom;
- AIDS or another condition that affects general resistance.
Because vaccination cannot prevent all cases of cervical cancer, it is necessary to have a smear test taken regularly. Currently, this is the only way the doctor can detect abnormalities that could lead to cervical cancer.
Simple and painless
A smear test is a fairly simple and painless test, but it can sometimes cause minor inconveniences, such as minor blood loss.
To take a smear, you lie on the examination table with your legs raised . Your feet rest on the table or on special leg supports. The doctor uses a speculum or metal instrument to view the inside of your vagina and cervix. The doctor will then remove some cell material from the inside of your cervix for examination.
You usually get the result within two weeks .
How often?
Women aged 25 and over who are (or have been) sexually active should have a smear test taken every three years by their GP or possibly by a gynaecologist.
From 50 to 65 years, the examination can be done every five years , provided that you have had smears taken regularly and that the last three smears showed no abnormalities and were of good quality.
However, an annual examination is recommended :
- with a previous abnormal smear;
- if you have previously undergone treatment of the cervix;
- if you have or had genital warts;
- if your immune system does not function optimally due to the use of medicines or illness.
A smear test is fully reimbursed by the health insurance once every three calendar years .
When not to have a smear taken?
- In case of inflammation of the cervix or vagina. The inflammation must then be treated first.
- During menstruation or other bleeding. The blood cannot properly assess the cells.
- During pregnancy and breastfeeding because the cells are more difficult to assess due to hormonal changes.
- If you are over 65 years old and the last two smear tests had a favorable result . It remains useful for women over 65 who have never had a smear test.
- If the previous smear was taken less than three months ago . After all, the superficial cell layer needs at least six weeks to recover.
Results
The result of a smear test indicates abnormalities much earlier than the first symptoms of cervical cancer, but never offers complete certainty .
The examination may prove to be unreliable in some cases, for example if insufficient cells have been removed, too many white or red blood cells are present, in the event of an infection or if the cells have not been removed correctly. In that case, a new smear is taken after three to six months.
Good to know
Via the Patient HealthViewer you will find all data about the population screenings for cervical cancer for which you have received an invitation.
Do not panic
If abnormal cells are found during a first smear, you do not need to panic immediately. After all, the cells that are removed are naturally subject to changes and not all cell changes point to cancer or are precursors to it. The previously identified abnormalities often appear to have disappeared during a repeat test without any treatment.
Further research
If a smear test gives an abnormal result, further investigation may be indicated to determine with certainty whether there is cancer or precursor lesions in the superficial mucosal layers of the cervix.
During a colposcopy, the doctor examines the walls of the vagina and cervix with a colposcope. That's a kind of magnifying glass. The doctor applies special dyes to the cervix. Abnormal cells absorb them so that they become visible. The doctor then removes small pieces of tissue with special forceps (= biopsy) for further examination under the microscope. This allows the nature of the deviation to be definitively determined.
It is a fast, simple , painless and cheap way to detect cervical cancer. You will receive the results within two weeks .
Cervical cancer is a cancer that develops slowly and can almost always be cured if detected early . The treatment depends on the severity of the identified injury, but also on other factors such as your age and possible desire to have children .
Precursor lesions
If there are precursor lesions, the affected tissue is destroyed or removed . This can be done in different ways .
- Cryosurgery
The affected tissue is destroyed by freezing. An anesthetic is not necessary. You don't have to stay in the hospital either.
- Laser treatment
The doctor destroys the affected tissue with laser light. This also does not require anesthesia and you do not have to stay in the hospital.
- Loop conization
The gynecologist removes the affected piece of tissue from the cervix under local anesthesia using a metal loop that is electrically heated.
- Conization
The gynecologist removes the affected tissue during a minor operation under local or general anesthesia. The upper part of the cervix is cut away. The cut-away piece has the shape of a cone. The uterus itself remains intact. This can be done in a day clinic or with a short hospital stay. The removed tissue can be used to check whether all abnormal mucous membranes have been removed with a sufficient margin.
Cervical cancer
If there is cancer, the doctor will first conduct further research into the stage of the cancer and its possible spread in the body. Based on this, he decides on the actual treatment (e.g. removal of the uterus, radio and/or chemotherapy).
Girls can be vaccinated against cervical cancer. The Gardasil9® and Cervarix® vaccines protect against, among other things, HPV types 16 and 18, which most often cause cervical cancer. Vaccination of girls who have not yet been infected with HPV would reduce their risk of cervical cancer by 70 percent.
The vaccine is also useful for boys . They can transmit the virus to girls through sexual contact, for whom it can cause cervical cancer. In addition, the virus can also cause cancer of the genitals and anus, cancer in the head and neck region or genital warts.
Safe sex
Because the vaccine cannot prevent all cases of cervical cancer and to protect you against other sexually transmitted infections , safe sex remains very important. Using a condom reduces the risk of HPV infection, but does not provide complete protection.
Elise Rummens
Elise is onze huisdokter. Haar stokpaardje op het vlak van gezondheid is beweging. Daarom zie je haar op dinsdagavond springen, vliegen, duiken, vallen en weer opstaan. Dan heeft ze haar wekelijkse parkourtraining.
Preventie-arts CM