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  Early diagnosis and treatment of the genital organ cancers

Prevention is better than cure

      Caring for Women's Health includes women of all ages, children, adolescents, pregnant women, women in generative age, women in perimenopause and postmenopause, preventively includes:

- examination of external genitalia, examination of vaginal secretions, PAPA examination, colposcopic examination
- ultrasound examination of the internal genitalia
- analisys in order to discover sexually- transmitted infections: HPV (Human Papillomavirus), chlamydial, herpes viral infections
- – brest examination (palpation and ultrasound)

Invasive cervical cancer is the second most common cancer in the world- with nearly half a million new cases each year- is 12% of all cancer cases in women.

The rate of appearance (INCIDENCE) was 19.1 per 100 000 in underdeveloped regions which is almost twice as much as in developed regions, where it was 10.3 per 100 000. Serbia has the highest incidence of cervical cancer (24.3 per 100 000) compared to all the other regions. In recent years, peak incidence of cervical cancer is moving towards younger age groups. Factors that increase the risk of all the changes include:

- genital infections (HPV)
- chemical carcinogenesis (smoking)
- immunosupression (HIV, conditions after organ transplantation )
- sexual habits (early sexual activity, promiscuity)
- factors relating to the male partner
- lifestyle (poor socio-economic conditions)

Goal of implementing the program for early detection of cervical cancer is to collect satisfactory smears from women of all ages under screening.

DETECTION METHODS are relatively simple, inexpensive, non-invasive (except biopsy) and highly sensitive and specific. These are:

- cytodiagnostics
- colposcopy
- histology
- HPV typing
CLINICAL CYTOLOGY - is diagnostic discipline in which the diagnosis is made by microscopic examination of desquamated epithelial cells ( in this case- cervix cells). Papanicolaou staining procedure was introduced into clinical practice in 1943.

COLPOSCOPY - is a microscopic examination of the external genitalia, vulva, vagina and cervix. Citology (Pap test) and colposcopy together in 95% of cases reveal premalignant lesions and early cancer of the cervix. Sometimes it is necessary for the accurate diagnosis to complete the examination with biopsy of the cervix.

General recommendations for taking the sample for cytological examination:

- explain to woman significance of taking the cytological smears
- smear is not taken during menses
- it is ideal to have a smear done 10-16 days after the start of your last period
- woman should not use any vaginal medication at the time of examination (vaginal medicines, contraceptives or washing 24 h to 48 h before examination)

Which women require examination?

1. the screening begins no later than 3 years after the beginning of sexual activity, but no later than the age of 20
2. after three consecutive normal cytological smear done in a year, women who belong to the low-risk group can repeat this examination once every 2 or 3 years
3. recommendation for sexually active women under the age of 30 years is to take the cytological smear annually
4. all the women who took these examinations regulary, after the age of 65 may suspend it

Ladies and friends, we remind you that prevention is the first step to good health and effective treatment. That is why You should think about Yours and the health of Your family before disease.

Dr Ćulibrk Bojan
Obstetrics & gynecology specialist