With more than 1 000 deaths a year, cancer of the cervix represents a major cause of cancer death in women in USA. In the beginning of its development cervic precancerous lesions are caused by virus of the papillomavirus (HPV) family.
Thanks to smear, it is possible to achieve a genuine screening. But according to a French team, the cancer risk assessment could be improved by supplementing it with a more precise identification of the virus.
Prevention
The cervicovaginal smear
The cervical smear is a simple consideration. It involves removing cells from the cervix by a simple painless scraping, and spread the levy on a slide. After fixing, the slides are examined under a microscope by a doctor specializing in this reading, the anatomical pathologist.
He describes in his cells report what he saw and can classify the smear in classes I to V, this is absolutely necessary, the description of cells must be sufficient to distinguish what is normal from what is suspect or frankly pathological.
All women who have sex should pass a smear test at two to one year intervals, and from the age of 25 years. It then seems sufficient to have a normal smear every three years until the age of 65 years. This frequency may be increased if the doctor considers it necessary.
The minutes of cervicovaginal smears will describe the epithelial cells observed, the hormonal state, the possible presence of inflammation, injury or dystrophic metaplasia, signs of viral infection papillomavirus (HPV) or neoplasia.
The cervical smear is an important consideration because it is simple, painless and can detect lesions at their very beginning, at a stage where treatment is extremely effective.
Treatment
It uses radiation (brachytherapy utérovaginale and cobalt) and surgery. Chemotherapy is used in some cases.
Brachytherapy utérovaginale is to put a radioactive source in the uterine cavity and vagina in direct contact with the tumor. The principle of a homogeneous high dose in a small volume, is the basis of efficiency and good tolerance of brachytherapy. The applicator is set up under general anesthesia. Once in place, it is loaded into a second time through a projector sources. Dosimetry is done by computer.
At the early stage, the intervention may be limited among young women still wanting children to a simple conization or amputation of the cervix under carefully examination. Among the older woman, removal of the uterus (hysterectomy simple total) is performed.
In more advanced forms, a wider surgery is performed, and may be associated with external radiation from the small basin.
The signs of the disease
There are no symptoms. It is a discovery of cervical screening done in the framework of the annual gynecologic or during medical surveillance of an inflammatory condition or cervical dysplasia (polyp, ulceration etc...)
When the cancer start to grow, the patient usually consults for loss of blood (Metrorrhagia) often caused by vaginal discharge (white losses) These symptoms are usually painless.
Anyway cervicovaginal smears are performed, and a colposcopy, which will allow the biopsy. The speculum examination may also reveal that the cervix is injured or ulcerated.
