Alerts to signs of cervical cancer

Cervical cancer remains a health problem and a cause of death among women in Mexico, said Dr. Mónica Durán Pérez, an oncology specialist at the Ministry of Health.

Statistics indicate that there are 13 to 18 cases of women diagnosed with this condition per 100,000 women. Six of them die from this cause.

In Yucatán, some statistics indicate a high incidence of this disease, with nearly 18 women per 100,000, and mortality is also very high, added the specialist, interviewed on the occasion of National Cervical Cancer Day, which is commemorated on August 9.

Cervical cancer is a malignant tumor that originates in the cells of the cervix, the structure that connects the vagina to the uterus. In most cases, it is caused by persistent human papillomavirus infection.

This disease, he added, continues to be a health problem, especially in low-income countries, such as those in Latin America, sub-Saharan Africa, and Southeast Asia. "Obviously, Mexico is included in this group."

In 2020, 600,000 new cases and around 300,000 deaths were reported, meaning 50% of diagnosed patients died from the disease, a very high rate, he warned.

In Mexico the situation does not differ much from what happens in the world.

The specialist emphasized that it's important to talk about these types of tumors because, compared to other cancers, they are preventable and can be detected early with regular checkups.

Internationally, women present with this type of cancer at age 50. Statistics in Mexico vary depending on the location of the study and indicate that the age ranges from 46 to 51. "However, we are seeing women with advanced disease at younger ages every day," she said.

"At O'Horán Hospital, we've had patients as young as 26. This is a red flag that speaks to a lack of access to screening programs, or even a lack of information and vaccination."

Risks

The most important risk factors are related to sexual behavior: starting sexual life at an early age, under 16 years of age, and having or having had multiple sexual partners or having only one but having additional partners.

Also, lack of access to Pap smears or follow-up care for low-grade neoplasia or dysplasia; confirmed human papillomavirus infection, the main risk factor for cervical cancer; and a history of other sexually transmitted infections.

Smoking cannot be ignored as an additional risk factor.

The specialist noted that cervical cancer is asymptomatic when the tumor is small. "As the tumor grows and invades other structures, it can cause bleeding that may be abnormal, including intermenstrual, sexual, or postcoital bleeding."

Also, frequent pelvic pain, "that cramping that's there continuously, is one of the main clues to suspect and seek immediate medical attention."

In women who become sexually active at 12 or 14 years of age, the cervical tissue is still immature and cannot defend itself against infections. Furthermore, these patients will have cumulative exposure throughout their lives, which makes them more susceptible to developing this type of cancer.

The earlier the age at which sexual activity begins, the greater the risk, the oncologist recalled.

He added that the Pap test is essential for early cancer detection, and guidelines indicate that it should be performed annually starting at age 25.

The recommendation is for all women because, although most cases are related to the human papillomavirus, a small percentage are not. "From the moment you become sexually active, you should get tested annually to identify any type of lesion."

"Smoking is a risk factor because its substances can promote cellular changes that lead to the development of tumors. Smoking creates an environment conducive to the development of a tumor if a cancer cell is already present."

She emphasized that detecting this cancer early and providing timely treatment makes the difference between life and death.— Claudia Sierra Medina

Cervical Cancer Immunization

The human papillomavirus vaccine is free in Mexico for girls and adolescents ages 10 to 14.

No contact

It is administered in public health facilities at these ages because it is more likely that at that point in life there has not been sexual contact or infection with the papillomavirus.

Other age ranges

For older women, the vaccine is available in the private sector and is administered if there is no history of human papillomavirus infection or suspicious Pap test results.

Dose

The vaccination schedule consists of three doses. Boosters are not necessary.

Serotypes

The biologic protects against nine serotypes of the virus. A small percentage of patients, despite immunization, develop the tumor, hence the importance of periodic Pap smears.