Symptoms and Risk Factors for Cervical Cancer

or cervical cancer is the leading cause of death from cancer for women in developing countries. Globally there are 600,000 new cases and 300,000 deaths each year, nearly 80% occur in developing countries. This is the biggest problem for the health of women in the present era.

 Those facts make cervical cancer ranks second cancer in women in the world, and ranks first in developing countries. Currently, cancer of the cervix into cancer in women Indonesia which is about 34% of all cancers in women, and now 48 million Indonesian women at risk of getting cervical cancer.What Is Cervical Cancer or Cervical CancerCervical cancer or cervical cancer is cancer that occurs in the area of ​​the cervix that is part of the uterus that connects the uterus to the top of the vagina. The average age of the incidence of cervical cancer is 52 years, and the distribution of cases reached the summit two times at the age of 35-39 years and 60-64 years. Cancer of the cervix itself is a malignancy that can be prevented due to:

1.     Having a pre-invasive era (before becoming a malignancy) long
2.     Cytology (cell) for early detection of cervical cancer is already available
3.     Therapeutic pre-invasive lesions (seed malignancy) is quite effective

Common Symptoms of Cervical CancerSo what symptoms to look? The most common symptoms of cervical cancer or cervical cancer is abnormal bleeding from the vagina or spots (spots) of the vagina. This is especially true of abnormal bleeding after sexual intercourse, but can also appear between two menstrual cycle bleeding, menorrhagia, or spotting / bleeding postmenopausal. If the bleeding lasts for a long time, the patient may complain tired and weak because they experienced anemia. Spotting yellowish watery followed by a fishy smell can be a sign of malignancy. Symptoms usually appear when the abnormal cells become malignant and infiltrate the surrounding tissue.In advanced stages, patients may complain smelling vaginal spotting, weight loss, and obstruction (blockage) in urination. If the cancer has spread to the pelvis, the back pain may occur followed by a bottleneck in urination and hydronephrosis (enlargement of the kidneys). Symptoms of bladder or rectum (hematuria, hematoschezia <CHAPTER bloody>, fistula) may be associated with spread to the bladder sertarektum on invasive tumors.For cervical cancer it can take up to a dozen years. Lesions (wounds or marks) early cervical cancer lesions may be an induration (hard) or ulcerations (sores), or areas that are a little elevation (rising) and granulated that bleed easily when touched.

risk factors for cervical cancer

Then what becomes the originator of cervical cancer? Some of the risk factors for cervical cancer are:

•     Race

    In the African-American race cervical cancer incidence increased by 2 times of American Hispanics. As for Asian-Americans have the same number of cases with the Americans. This relates to socio-economic factors.

•     Sexual and reproductive factors

    First sexual intercourse before the age of 16 years associated with an increased risk of cervical cancer 2 times compared with women who had sexual intercourse after the age of 20 years. Cervical cancer is also associated with the number of sexual partners. The more sexual partners increases the risk of cervical cancer. Increased parity (number of pregnancies) is also a risk factor for cervical cancer.

•     Smoke

    Smoking is an important cause of cervical cancer, squamous cell carcinoma types. The risk factors increased 2 times with the highest risk was found in those who smoke for long periods of high intensity (number of lots).

•     Contraception

    The use of contraceptive pills in the long term (5 years or more) increases the risk of cervical cancer 2 times. The use of barrier contraceptive method (barrier), especially those using a combination of mechanical and hormonal show a decline in the incidence of cervical cancer is estimated as a decrease in exposure to the causative agent of infectious

•     Conditions immunosuppression (decreased immunity)

    In immunocompromised women (decreased immunity) such as kidney transplants and HIV, can accelerate (speed up) the growth of cancer cells become invasive non-invasive (malignant not become malignant)

•     Infection with HPV (Human Papilloma Virus)

    Epidemiologic studies show that HPV infection was detected using molecular research on the 99.7% of women with squamous cell carcinoma for HPV infection is the cause of the mutation neoplasms (transformation of normal cells into malignant cells). There are 138 strains of HPV have been identified, 30 of which can be transmitted through sexual intercourse. Of all the types of HPV that attack anogenital (anal and genital), there are four types of HPV that commonly cause problems in humans like two HPV subtypes with a high risk of malignancy, namely types 16 and 18 were found in 70% of cervical cancers, and HPV types 6 and 11, which cause 90% of cases of genital warts (genital warts)

Periodic examination for all women especially those who have risk factors using the Pap smear is an effective way to detect early cervical cancer and early and adequate treatment. In addition to the pap smear, another method is visual inspection with acetic acid (VIA) or Lugol's Iodine (VILI) and HPV-hybrid capture. The test is easy to do and have effective results. Screening is done 3 years of becoming sexually active and repeated annually.The most ideal treatment of cancer is early detection. The earlier detected, the better the handling steps that can be taken. Therefore, the next page explains how the stages of cervical cancer in the body.Cancer of the cervix can spread to different organs. Among them into the lymph nodes, vagina, bladder, rectum, endometrium (lining of the wall of the uterus) and ovaries (ovarian). Each providing different symptoms. The spread of cervical cancer in general through the circulation of the lymph nodes, the spread through blood circulation rare.

StadiumInternational of Gynecology and Obstetrics (FIGO) staging system used for the evaluation and diagnosis of cervical cancer based on symptoms. Stadium by FIGO namely:

•     Stage I. Cancer of the cervix is ​​found only in the neck (cervical)

    -Stadium IA. Invasive cancer diagnosed by microscopy (using a microscope), the spread of tumor cells reach the stromal layer of no more than a depth of 5 mm and a width of 7 mm. Stage IA1. Invasion of the stromal layer as deep as 3 mm or less with a width of 7 mm or less. Stage IA2. Stromal invasion between 3- 5 mm inside and with a width of 7 mm or less.
    -Stadium IB. Tumors were seen only in the cervix or microscopic examination is deeper than 5 mm with a width of 7 mm. Stage IB1. Tumors were spotted along the 4 cm or less. Stage IB2. Tumors appear longer than 4 cm.

•     Stage II. Cancer extends out from the cervix but does not reach the pelvic wall. Spreading involve upper 2/3 of the vagina.

    -Stadium IIA. Cancer does not involve the connective tissue (parametrial) around the uterus, but involve upper 2/3 of the vagina.
    -Stadium IIB. Cancer involves parametrial but does not involve the pelvic sidewall.

•     Stage III. Cancer extends to the pelvic sidewall and the third involves the lower vagina. Stage III includes cancer that inhibits urination, causing heap of urine in the kidneys and cause kidney disorders.

    -Stadium IIIA. Cancer involves the lower third of the vagina but do not extend to the pelvic wall.
    -Stadium IIIB. Cancer extends to the side wall of the vagina causes urinary disorders resulting in renal impairment.

•     Stage IV. Tumors spread to the bladder or rectum, or spread beyond the pelvis.

    -Stadium IVA. Cancer spread to the bladder or rectum.
    -Stadium IVB. Cancer spread to distant organs