Cervical cancer prevention and screening
1. Regular gynaecological examinations
Cervical cancer can be relatively easily prevented by having regular gynaecological examination each year. A regular gynaecological checkup can reveal the so-called precancerous lesions which can be treated very effectively. Of course, some changes might pass unnoticed – particularly the so-called endocervical tumours, which are located outside the reach of cervical smear; if these changes should later develop into cancer, they would be almost certainly revealed as precancerous lesions during the subsequent examination, with a chance of complete cure exceeding 95%.
2. Safer sex
Having a steady partner – or using condom consistently if there is no steady partner – is another important preventive measure. In 99% of cases, cervical cancer is caused by the human papillomavirus (HPV), which is very easily transmitted during sexual intercourse.
3. HPV vaccination
There are currently three HPV vaccines licensed (i.e., doctors can prescribe them) in the Czech Republic. The first vaccine protects the immunised person against two high-risk HPV types (namely HPV16 and HPV18), which have been linked to cervical cancer in the vast majority of cases. The second vaccine protects against four HPV types: two high-risk (HPV16 and HPV18) and two low-risk (HPV6 and HPV11), which have been linked to most cases of genital warts. The third vaccine is nonavalent; in other words, it protects the immunised person against nine HPV types, thus providing the most comprehensive protection against HPV-related diseases (cervical cancer, vulvar cancer, vaginal cancer, anal cancer, precancerous lesions and genital warts).
HPV vaccines prevent the development of not only carcinomas, but also of precancerous lesions, which might later lead to the development of malignant tumours. These vaccines contain non-infectious viral proteins that are able to induce the production of antibodies by the body’s own immune system. If the body later encounters HPV infection, its antibodies are able to suppress it.
HPV vaccines are aimed to prevent HPV infection. They provide the best protection to girls and boys who have not started their sex life yet. However, HPV vaccination markedly decreases the risk of HPV-related diseases even after the start of a person’s sex life. Girls and boys aged over 9 years can be immunised with HPV vaccines. HPV vaccination of thirteen-year-olds is reimbursed by health insurance companies in the Czech Republic (one of the available vaccines is fully reimbursed, the remaining ones are partially reimbursed) and is performed by general practitioners for children and adolescents. Adult women can be vaccinated by their gynaecologists, adult men and women can contact their general practitioners; outpatient specialists in some specialties (urology, dermatology, venereology, otorhinolaryngology etc.) can also be involved.
Vaccination protects women and girl against HPV types addressed by the chosen vaccine. It does not provide protection against other HPV types. This is the reason why vaccination is not the only way of cervical cancer prevention. Vaccinated women will still need to attend their routine cervical smear tests (performed during preventive gynaecological examinations). Based on regular check-ups, the gynaecologist can monitor the cervix in the long term and reveal potential abnormalities.
4. Other preventive measures
HPV infection is a necessary but insufficient condition for the development of cervical cancer. There are many other factors contributing to the development of cancer, such as smoking, unhealthy diet or other examples of unhealthy lifestyle. You can find more information on cancer prevention on specialised websites.