Cervical cancer, also known as cervical carcinoma, is a malignant growth that occurs in the cells of the cervix. This disease can affect individuals at any age, and the risk increases as one gets older.

In Indonesia, cervical cancer ranks second after breast cancer as the most common type of cancer in 2020, with over 36,000 cases and 21,000 deaths recorded.

CAUSES AND RISK FACTORS

Almost all cases of cervical cancer are caused by an infection from the Human Papillomavirus (HPV), particularly the oncogenic subtypes 16 and 18. Cervical cancer begins when healthy cells in the cervix undergo changes (mutations) in their DNA.

In addition to HPV, there are other risk factors that can increase the likelihood of cervical cancer, including:

- Having multiple sexual partners

- Engaging in sexual activity at a young age

- Smoking

- Sexually transmitted infections, particularly chlamydia

- Family history of cervical cancer

- Multiple pregnancies and childbirths

- Immune system disorders

However, cervical cancer is the only type of cancer that can be prevented and detected early through methods such as Pap smear tests. Early diagnosis significantly increases the chances of successful treatment.

SYMPTOMS

The high incidence of cervical cancer is primarily due to a lack of awareness about the disease. In the early stages, cervical cancer may not exhibit any symptoms. However, more advanced stages of cervical cancer are characterized by various signs, such as:

- Abnormal vaginal bleeding outside of menstruation

- Vaginal bleeding during sexual intercourse (contact bleeding)

- Excessive and foul-smelling vaginal discharge

- Pelvic, back, or leg pain

- Discomfort or pain during urination

- Loss of appetite resulting in weight loss

- Fatigue and weakness

DIAGNOSIS 

When symptoms suggestive of cervical cancer arise, several diagnostic tests can be performed to confirm the diagnosis, determine the stage of the cancer, and assess its spread.

Screening tests:

Screening tests are conducted to detect cervical cancer and diagnose pre-cancerous cell changes that may develop into cervical cancer in the future. Common screening tests include Pap smears, visual inspection with acetic acid (VIA), HPV DNA tests, and HPV mRNA tests.

Advanced tests:

If an initial diagnosis suggests cervical cancer, further examinations may be necessary. These may include:

- Colposcopy to examine abnormal cells in the cervix

- Biopsy

- Complete blood count

- Imaging tests such as X-ray, CT scan, MRI, and PET scan.

TREATMENT FOR CERVICAL CANCER

The treatment for cervical cancer varies depending on the severity or stage of the cancer. Options may include:

- Surgery: Surgical procedures are only viable for early-stage cervical cancer. The aim is to remove the cancerous tissue.

- Radiation therapy: This treatment is commonly used in the early stages of cervical cancer and can be combined with surgery or chemotherapy, depending on the severity.

- Chemotherapy: Chemotherapy is an effective treatment method for various cancers, including cervical cancer. It can be used as a standalone treatment or in combination with radiation therapy.

- Hysterectomy: This procedure involves the removal of the uterus and is performed when the cancer has advanced. It renders the patient unable to conceive and leads to early menopause.

PREVENTION OF CERVICAL CANCER

Cervical cancer is the only type of cancer that can be prevented through two approaches:

• Primary prevention through HPV vaccination. This is because 80-100% of cervical cancer cases are caused by oncogenic HPV types 16 and 18.
• Secondary prevention of cervical cancer through Visual Inspection with Acetic Acid (VIA), Pap smears, and HPV DNA tests.

Additionally, it is recommended to adopt a healthy lifestyle by consuming nutritious and balanced food to prevent various diseases, including cervical cancer. Increase your intake of vegetables rich in beta-carotene, vitamin C, and vitamin E. It is also advisable to avoid engaging in sexual activity at a young age and having multiple sexual partners.

Author: Dr. Puppy Nawangwulan (Medical Laboratory Services at PRAMITA Clinic, Jl. Jemur Andayani No. 67, Surabaya)