Cervical cancer - prevention or treatment?

Cervical cancer – prevention or treatment?

The negative statistics of cervical cancer are well-known, very striking, and, unfortunately, quite real. Every year, 270,000 women die of cervical cancer worldwide, one woman every 2 minutes. In Europe, this happens every 18 minutes. In Bulgaria, one woman dies every day and 3 new cases are diagnosed. The worst thing about these figures is that cervical carcinoma is the only one that can be completely prevented and cured if it is diagnosed in time.

In order to encourage women to take small steps towards a healthy and happy life, specialized oncology and mammology prevention rooms in the complex offer preventive programs aimed at preventing women’s health. Notable among these are specially designed benefit packages for the annual prevention of gynecological diseases and for cervical cancer screening.

The figures in Bulgaria for this type of cancer show increasingly alarming results, which puts us in one of the last places in Europe and in the middle of the world. Our country is characterized by a continuous increase in mortality and morbidity, as well as an unfavorable staging distribution. Patient staging, in turn, is the most accurate indicator of the effectiveness of screening and early diagnosis programs.

Countries with the lowest rates have well-designed and optimized screening and prevention programs. An example of such a country is Finland, where about 80-85% of the population is covered by organized screening. Unlike other European countries that focus primarily on prevention and prevention, providing quality medical care to their residents, in Bulgaria the emphasis is on the treatment of oncological diseases that have already arisen.

The main measures that can be taken against cervical cancer are various types of prevention. Primary prevention includes measures to influence the external and internal environment of a person in order to eliminate or reduce carcinogens and predisposing factors. Secondary prevention combines methods for detecting malignant tumors at an early stage, or at a stage preceding the development of cancer.

This formulation is based on the concept of carcinogenesis, namely that cancer does not occur suddenly, but is the result of various antecedent changes. Tertiary prevention carries out active monitoring of already treated patients and is aimed at carrying out anti-relapse and rehabilitation measures. Primary prevention in this case is based on HPV vaccination, which requires a nationally initiated and funded campaign.

The introduction of primary prevention certainly does not cancel the introduction of secondary prevention. It relies on various types of screening (mass and opportunistic). Mass screening is again a matter of public policy and strategy.

In Bulgaria, programs for the prevention and screening of cancer are currently completely absent or are being started sporadically. As a result, our country occupies one of the first places in terms of incidence and mortality from cervical cancer. Following the philosophy of Associate Professor Atanas Shterev that medical institutions should be socially responsible and actively and independently participate in the so-called opportunistic screening, we at the Doctor Shterev Medical Complex are developing various actions to popularize oncological and gynecological preventive examinations and preventive medicine activities.

This activity is based on the understanding that due to the lack of a mass examination in our country and any other involvement of the state in this problem, every responsible obstetrician-gynecologist and specialized medical institution should join the fight against cervical cancer. Each gynecological examination should have an oncological focus (opportunistic screening).

We are engaged in the prevention and treatment of precancerous conditions detected through our screening program, which is applied in the specialized sector of preventive medicine. With us, we provide optimal screening for all our patients in the hope of improving the frightening statistics to the best of our ability, even if they are minimal in the background of the whole country.

In order to optimize our screening program, we opened a histopathological laboratory on the territory of the complex to study histological and cytological materials. We have replaced the standard smear with a new generation of cytology (much more sensitive and with better diagnostic value) and equipped the sector with a specialized processor Thin Pre .p, through which the latest method of performing smears using liquid technology is used. We have replaced the standard colposcopy machine with an HD video colposcope.

In order to conduct a high-quality and adequate oncoprophylactic gynecological examination, in addition to oncocytoma, a colposcopic examination is recommended. The method has been known for a long time, but, unfortunately, it is little used by obstetricians and gynecologists in our country. Thus, we could get a more complete picture of the condition of the cervix and, if necessary, provide an adequate diagnosis and treatment of our patients. Video colposcope, in turn, provides many opportunities:

  • each feedback is recorded and stored;
  • allows our patients to consult with colleagues from the country and from abroad;
  • provides better control over the condition of treated patients;
  • an electronic file of examined patients is created.

In conclusion, we can say that adequate and high-quality prevention will completely replace the need for treatment. We believe that prevention saves lives, but treatment, unfortunately, cannot always.


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