Minggu, 29 Mei 2011

Prevention of Cervical Cancer

Prevention of Cervical Cancer

Most cervical cancers can be prevented. There are 2 ways to prevent this disease. The first way is to find and treat pre-cancers before they become cervical cancer, and the second is to prevent the occurrence of cervical pre-cancer.

Pap Smear Test: named according to its inventor, Dr. George Papanicolaou (1883-1962) of Greece. This test is used to reveal whether there is infection, inflammation, or abnormal cells in the cervix (neck of the womb).

Pap smear test can be performed in hospitals, clinics or laboratories nearest obstetrician. The procedure is quick (only takes a few minutes) and painless.

Pap smear test can be done when you are not in a state of menstruation or pregnancy. For best results, you should not have sex at least 3 days before the examination.
Figure 1: The doctor inserts (tool) speculum into the vagina to hold the vaginal walls open.
Figure 2: Liquid / cervical mucus is taken by rubbing (tool) spatula.
Figure 3: The swab was then applied to the object-glass
Figure 4: The sample is ready to be brought to the pathology laboratory for examination.

Type of Test Pap Smear:

Conventional Pap smear test
As the picture above.
Thin prep Pap.
Usually done when the results of the conventional Pap smear test is not good / obscure. Mucus samples were taken with a special tool (cervical brush), not with a wooden spatula and the results are not added to the object-glass, but sprayed with a special liquid to separate contaminants, such as blood and mucus so that the results more accurate.
Thin prep plus HPV DNA test
Done when the Pap smear test results is less good. Samples examined whether HPV DNA.


The women should begin Pap smear test about 3 years after they started having sex, but not older than age 21 years.
Testing should be done every year if the regular Pap smear tests are used, or every 2 years if liquid-based Pap test used.
Starting at age 30, women who have a NORMAL test results as much as 3x in a row may be able to undergo a Pap smear test every 2 to 3 years. Another option for women over 30's is undergoing a Pap smear test every 3 years plus the HPV DNA test.
Women who have certain risk factors (such as HIV infection or have a weak immunity) should get a Pap smear every year.
Women aged 70 years or older with Normal Pap test results for 3 years in a row (and had no abnormal test results in the last 10 years) may choose to stop doing Pap smear test this. But women who had cervical cancer or who have other risk factors (as mentioned above) should continue to pull through this test as long as they are in good health.
Women who had undergone total hysterectomy may also choose to stop doing Pap test unless it has undergone surgery to treat cervical cancer or pre-cancer. Women who had undergone a simple hysterectomy (cervix is ​​not removed) must still follow the guidelines above.

Some women believe that they can stop doing Pap smear tests after they stop having children. This is not true. They should continue to follow the guidelines above.

Pelvic examination vs. Pap Smear Test

Many people are often confused between a pelvic examination vs. Pap smear tests, perhaps because both of these things are often done at the same time. Pelvic exam is part of a woman's routine health care. During this examination, the doctor may see and feel the reproductive organs. Some women think that they do not need a pelvic exam after they stop having children. This is not true.

Pelvic exams can help find diseases of the female organs. But it's not going to find cervical cancer at an early stage. For that, the Pap smear test is required. Pap smear test is often done just before the pelvic examination.

Another alternative Pap Smear Tests: Methods IVA

For early detection of cervical cancer, in addition to the Pap smear test, other methods which may be an option is the VIA (Visual Inspection with Acetic Acid).

IVA is used to detect abnormalities in your cervical cells after applying acetic acid solution (cuka3 acid-5%) of the cervix. Acetic acid confirm and mark the pre-cancerous lesions with somewhat whitish discoloration (acetowhite change). The result can be known right away, or within 15 minutes.

IVA method contains an advantage over a Pap smear test, because it is very simple (can be done in the PHC), the result is quite sensitive and very affordable prices (from USD. 5000).

Unlike the Pap smear test, examination method IVA can also be done anytime, including during menstruation, during childbirth or post-abortion care. If the result is nice, visit VIA test is repeated for every 5 years.

Images: Various VIA test results

Cause Cervical Cancer

Cervical Cancer Risk Factors

The risk factors below can increase a woman's chance of cervical cancer:

Infection with Human Papilloma Virus (HPV)

In cervical cancer, the most important risk factor is infection with HPV (human papilloma virus). HPV is a group of more than 100 related viruses that can infect cells on the skin surface, is transmitted through skin contact such as vaginal, anal, or oral sex.

Low-risk HPV virus can cause genital warts (genital wart disease) that can heal itself with immunity. But in high-risk HPV virus types (types 16, 18, 31, 33 and 45), the virus can alter the surface of vaginal cells. If not immediately detected and treated, the HPV virus infection in the long run this can cause cells to form pre cervical cancer.

Unsafe sex, especially at a young age or having multiple sex partners, allowing the occurrence of HPV infection. Three of the four new cases of HPV infection attacks the young women (aged 15-24 years). HPV Virus Infection can occur within the first 2-3 years they are sexually active.

At the age of adolescents (12-20 years) female reproductive organs are actively growing. Stimulation of the penis / semen can trigger changes in the nature of the cells become abnormal, especially if the injury occurs during intercourse and then infection with HPV virus. These abnormal cells that contain high potential cause of cervical cancer.

Now there are several vaccines that prevent infection from some types of HPV.

Other Risk Factors

Smoking: Women who smoke are two times more likely to get cervical cancer than those who do not. Cigarettes contain many toxic substances / chemicals that can cause lung cancer. Hazardous substances were brought into the bloodstream throughout the body to other organs as well. By-products (by-products), cigarettes are often found in cervical mucosa of women smokers.

HIV infection: HIV (human immunodeficiency virus) is the virus that causes AIDS-is not the same with HPV. It can also be a risk factor for cervical cancer. Having HIV somehow make a woman's immune system less able to fight both HPV infection and cancers at an early stage.

Chlamydia infection: This is a common bacteria that attacks the organs of women, spread through sexual intercourse. A woman may not know that he was infected but do test for chlamydia during a pelvic exam. Some research found that women who have a history or current infection are at risk of cervical cancer is higher. Infection in the long run can also cause other serious problems.

Diet: What you eat can also play a role. Diet low in vegetables and fruits may be associated with increased risk of cancer seviks. Also, women are obese / overweight are at higher risk.

Birth control pills: Use of birth control pills in the long term may increase the risk of cervical cancer. Research found that the risk of cervical cancer increases with the longer women used the contraceptive pill and tends to decrease when the pill on-stop. You should discuss with your doctor about the pros cons of the use of birth control pills in your case. Have Many Pregnancy: Women who underwent 3 or more intact pregnancies at increased risk of cervical cancer. No one knows why this could occur.

First pregnancy at a young age: Women who get pregnant the first at age under 17 years almost always 2x more likely to develop cervical cancer in old age, than women who delay pregnancy until the age of 25 years or older

Low Income: Poor women are at risk of cervical cancer is higher. This may be because they are unable to obtain adequate health care, such as Pap smear tests regularly.

DES (diethylstilbestrol): DES is a hormonal drug that was used between the years 1940-1971 for some women who are in danger of miscarriage. Female children of women who use these drugs, when they are pregnant are at risk of cervical and vaginal cancer is slightly higher.

Family History: Cervical cancer may run in some families. When Mom or your sister has cervical cancer, your risk of this cancer can be 2 or 3 times as much from others who are not. This may be because women are less able to fight HPV infection than other women in general.

What is Cervical Cancer

Cervical cancer is a malignancy that occurs in the cervix. Cervical cancer is also called cervical cancer or cervical cancer begins in the lining of the cervix. 

Cervical cancer is formed very slowly. First, some changes from normal cells into cells pre-cancerous and then into cancer cells. This can happen for many years, but sometimes it happens faster. These changes are often called dysplasia. They can be found with Pap smear tests and can be treated to prevent cancer. 

To understand cervical cancer, it helps us understand the anatomy of a woman's uterus in advance. 

Rahim female anatomy

Neck of the womb (cervix) is the bottom of the uterus (womb). Rahim has 2 parts. The upper part, called the body of the uterus, is where the baby grows. The cervix, at the bottom, connecting the body uterus to the vagina, also called the birth canal. 

Image of female reproductive organs:

There are 2 main types of cervical cancer. Approximately 8-9 out of 10 species present is squamous cell carcinoma. Under the microscope, this type of cancer formed by cells such as squamous cells that cover the surface of the cervix. Most of the remainder are adenocarcinoma. Cancer begins in cells that make mucus glands. Rarely, cervical cancer have both kinds of features above and is called mixed carcinoma.Other species (such as melanomas, sarcomas, and lymphomas), which most often occurs in other parts of the body. If you have cervical cancer, ask your doctor to explain what type of cancer you have. 

How many women get cervical cancer?

The number of women with cervical cancer prevalence in Indonesia is quite large. Every day, found 40-45 new cases with the number of deaths reaches 20-25 people. While the number of women at risk of the virus reaching 48 million people. Doctor Laila Nuranna SpOG (K), Head of Oncology Division of Obstetrics Gynecology, Faculty of Medicine, University of Indonesia, said that most cases of cervical cancer were detected in hospitals has been so difficult to treat advanced stage. "If the cancer is found early, the handling will be easier and greater life expectancy," he said during a discussion Effort Campaign and Cervical Cancer Treatment at the Hotel Lumire Jakarta, Monday, April 12, 2010. 

Some researchers think that non-invasive cervical cancer (which only occurs in the cervix when found) is about 4 times more common than invasive cervical cancers. When found and treated early, cervical cancer often can be cured. 

Cervical cancer tends to occur in middle-aged women. Most cases are found in women who are under 50 years. It rarely occurs in young women (aged 20 years). Many women do not know that when you get old, they are still at risk for cervical cancer. That is why it is important for older women to continue to undergo regular Pap smear tests 

Kanker Serviks

Apa itu Kanker Serviks

Kanker serviks adalah keganasan yang terjadi pada leher rahim. Kanker serviks disebut juga kanker leher rahim atau kanker mulut rahim dimulai pada lapisan serviks.

Kanker serviks terbentuk sangat perlahan. Pertama, beberapa sel berubah dari normal menjadi sel-sel pra-kanker dan kemudian menjadi sel kanker. Ini dapat terjadi bertahun-tahun, tapi kadang-kadang terjadi lebih cepat. Perubahan ini sering disebut displasia. Mereka dapat ditemukan dengan tes Pap Smear dan dapat diobati untuk mencegah terjadinya kanker.

Untuk dapat memahami kanker serviks, ada baiknya kita memahami terlebih dahulu anatomi rahim wanita.

Anatomi Rahim wanita

Leher rahim (serviks) adalah bagian bawah uterus (rahim). Rahim memiliki 2 bagian. Bagian atas, disebut tubuh rahim, adalah tempat di mana bayi tumbuh. Leher rahim, di bagian bawah, menghubungkan tubuh rahim ke vagina, atau disebut juga jalan lahir.

Gambar organ reproduksi wanita:
Kanker Serviks Vagina

Ada 2 jenis utama kanker serviks. Sekitar 8-9 dari 10 jenis yang ada adalah karsinoma sel skuamosa. Di bawah mikroskop, kanker jenis ini terbentuk dari sel-sel seperti sel-sel skuamosa yang menutupi permukaan serviks. Sebagian besar sisanya adalah adenokarsinoma. Kanker ini dimulai pada sel-sel kelenjar yang membuat lendir. Jarang terjadi, kanker serviks memiliki kedua jenis fitur diatas dan disebut karsinoma campuran. Jenis lainnya (seperti melanoma, sarkoma, dan limfoma) yang paling sering terjadi di bagian lain dari tubuh. Jika Anda memiliki kanker serviks, mintalah dokter Anda untuk menjelaskan jenis kanker apa yang Anda miliki.

Berapa banyak wanita terkena kanker serviks ?

Jumlah prevalensi wanita pengidap kanker serviks di Indonesia terbilang cukup besar. Setiap hari, ditemukan 40-45 kasus baru dengan jumlah kematian mencapai 20-25 orang. Sementara jumlah wanita yang berisiko mengidapnya mencapai 48 juta orang. Dokter Laila Nuranna SpOG(K), Kepala Divisi Onkologi Ginekologi Obstetri Fakultas Kedokteran Universitas Indonesia, mengatakan bahwa sebagian besar kasus kanker serviks yang terdeteksi di rumah sakit sudah stadium lanjut sehingga sulit diobati. "Jika kanker ditemukan lebih dini, penanganannya akan lebih mudah dan tingkat harapan hidup lebih besar," katanya saat Diskusi Kampanye dan Upaya Penanganan Kanker Serviks di Hotel Lumire Jakarta, Senin 12 April 2010.

Beberapa peneliti berpikir bahwa kanker serviks non-invasif (yang hanya terjadi di leher rahim ketika ditemukan) adalah sekitar 4 kali lebih umum daripada jenis kanker serviks yang invasif. Ketika ditemukan dan diobati secara dini, kanker serviks seringkali dapat disembuhkan.

Kanker serviks cenderung terjadi pada wanita paruh baya. Kebanyakan kasus ditemukan pada wanita yang dibawah 50 tahun. Ini jarang terjadi pada wanita muda (usia 20 tahunan). Banyak wanita tidak tahu bahwa ketika menjadi tua, mereka masih beresiko terkena kanker serviks. Itulah sebabnya penting bagi wanita lebih tua untuk tetap menjalani tes Pap Smear secara teratur 

©2009 Dokter Kanker | by TNB