The National 14 February 2019
by Dr Mathias Sapuri
The World Health
Organization (WHO) recommends a comprehensive approach to cervical cancer and
control. There are three levels of prevention – primary, secondary and
tertiary.
Primary prevention begins with HPV vaccination of girls
aged 9-14 years before they become sexually active. There should be focus on
the dangers of tobacco use which is an important risk factor.
There are 3 types of
screening tests recommended by WHO. (1) HPV testing for high risk HPV types (2)
visual inspection with acetic acid and (3) conventional PAP test and liquid
based cytology.
For treatment of
pre-cancer lesions WHO recommends cryotherapy and loop exosurgical excision.
Symptoms of early stage cervical cancer may include (1)
irregular blood spotting or light
bleeding (2) postmenopausal spotting or bleeding (3) bleeding after sexual
intercourse (4) increased vaginal discharge at times foul smelling.
As cervical cancer advances, more
severe symptoms may appear including (1) persistent back, leg or pelvic pain
(2) weight loss, fatigue or loss of appetite (3) foul smelling discharge and
(4) swelling of leg or lower
extremities.
Treatment depends on the stage of
the disease and options include surgery, radiotherapy or chemotherapy.
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