WHY EARLY DETECTION OF CERVICAL CANCER IMPORTANT, AND HOW TO DO IT?

Cancer is still one of the major health problems in the world, especially in developing countries. Of all cancer in women in Indonesia, cervical cancer ranks second after breast cancer. One effort to reduce the incidence of cervical cancer is to promote health, especially with primary prevention.

            Female reproductive organs consist of vulva, vagina, uterus, fallopian tubes and ovary, all of which can be affected by cancer. Cervical cancer is cancer that occurs in cervical cells, which is an organ located in the lowest part of the uterus that is connected to the vagina.

            The main cause of cervical cancer is high risk human papillomavirus (HPV), which is mainly transmitted through sexual contact.           This is supported by several risk factors such as: multiple sexual partners, early sexual activity, having others sexual transmitted disease, a weak immune system, and smoking. Most women who have active sexual activity will be infected by HPV, but often without symptoms and infection can disappear and only cause minor changes in cervical cells that can return to normal. In some women, this infection can persist, so infected by high risk HPV occur for a long time, so there will be more severe changes in cervical cells, which can develop into cancer.

            Early detection is important because to be able to develop from a precancerous change of high degrees into cancer, it takes quite a long time, which is between 3-7 years. Early detection will be able to find cell changes before developing into cancer. Women with mild precancerous changes can be examined more frequently to find out if the affected cells have return to normal. Women with high-grade precancerous changes can be treated immediately so that they do not develop into cancer.

            Screening can be a pap smear and HPV test. This examination is done by taking cells in the cervix in a way that is quite simple and fast. To avoid misinterpretation of cells, then before doing a pap smear, avoid using drugs in the vagina and sexual contact 2 days before, and not menstruating. When taking the specimen the patient sleep on her back, the vagina is opened using a speculum to see the cervix and upper vagina, then the cells are taken with a spatula or brush,thenexamined in the laboratory. Pap smear can be done in health facilities such as health centers, laboratories, midwives or private practice doctors or in hospitals. Pap smear examination is useful to see the presence or absent of abnormal cells, while the HPV test to determine about 13-14 the most common types of high-risk HPV. In women aged 21-29 years, they must have a pap smear every 3 years if there are no abnormalities. The HPV test is not recommended. Women aged 30-65 years old must have a pap smear and HPV test (co-test), every 5 years. Can also do pap smears every 3 years, if no abnormalities are found. Women over the age of 65 can stop screening if they do not have a moderate to severe precancerous history or a history of cervical cancer. Screening can also be stopped if you have negative pap smear results three times in a row or negative co-test results twice in a row in the last 10 years, and the test is done within the last 5years. Women who have been vaccinated against HPV should still follow the screening schedule according to the recommended age group.

            Many women get abnormal pap smear results, which is not always positive for cancer. If the result is inflammation or reactive changes, treatment is needed according to the cause. If there is a suspicious of precancerous abnormality or cancer, a pap smear repeat or biopsy colposcopy examination is required. Subsequent therapy and subsequent pap smear tests will be carried out according to existing protocol.