[칼럼] Early detection is important! What are the signs of cervical cancer?

Uterine cancer can be divided into cervical cancer and uterine body cancer according to the location of its occurrence. Cervical cancer is cancer that occurs at the entrance to the uterus (cervix), and cancer cells develop at the entrance to the uterus, which is connected from the vagina to the cervix. Cancer that occurs in the body of the uterus, often referred to as endometrial cancer, is cancer that develops in the endometrium, the innermost part of the uterine sac where the fetus grows.

Cervical cancer and endometrial cancer have a relatively easy-to-understand symptom of ‘small amount of vaginal bleeding’, so they have a good prognosis because they can be detected relatively early compared to ovarian cancer, which is called the silent assassin. If you ignore the symptoms of vaginal bleeding and do not receive regular checkups, symptoms such as odorous discharge, lower abdominal pain, and excessive bleeding may appear.

Cervical cancer is primarily associated with human papillomavirus (HPV). Human papillomavirus infection is mainly transmitted through sexual intercourse, that is, it can appear in all sexually active women, so it is a virus so common that 80% of women are infected once. Liquid cervical cytology, performed for early detection of cervical cancer, is a test in which cells are obtained by rubbing the cervix with a brush, and then smeared on a slide to observe the shape under a microscope. Depending on the shape of the cells, it is divided into normal, atypical squamous cells, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, and atypical glandular cells. If abnormal findings are found, biopsy is performed for accurate diagnosis. When diagnosed as stage 3 cervical intraepithelial tumor, sometimes expressed as stage 0 of cervical cancer, a simple operation (cervical coneectomy) can prevent the progression to cervical cancer while preserving fertility. In the case of cervical cancer, surgery can be performed immediately if it is early and the prognosis is good.

According to data from the Health Insurance Review and Assessment Service, the number of patients treated for endometrial cancer increased by about 50% from 11,629 in 2013 to 17,421 in 2017. It is known to show a steep increase in young women in the teenage years. The increase in endometrial cancer can be attributed to improved nutritional status and increased proportion of obese women. In addition, if the age of menarche is early or menopause is late, if a woman who has never given birth or a drug that can affect female hormones is administered for a long time, the probability of getting endometrial cancer increases.

If you have risk factors, have vaginal bleeding after menopause in addition to regular examinations, or have irregular bleeding at times other than menstruation, you need an ultrasound to check the condition of the endometrium. If endometrial lesions are suspected on ultrasonography, biopsy is performed for an accurate diagnosis. Since endometrial hyperplasia can progress to endometrial cancer in 1-29% of cases, hormone therapy or surgical treatment can reduce the risk of cancer. In the case of endometrial cancer, early detection is important as it has a high cure rate with a survival rate of more than 85% for more than 5 years in the early stages.

Liquid cervical cytology and pelvic ultrasonography are recommended for regular obstetrics and gynecology examinations.

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