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Cervical Cancer Journal PDF
Cervical cancer is a largely preventable disease, but worldwide it is one of the leading causes of cancer death in women. Most deaths occur in low- to middleincome countries.
- The primary cause of cervical pre-cancer and cancer is persistent or chronic infection with one or more of the “high-risk” (or oncogenic) types of human papillomavirus (HPV).
- HPV is the most common infection acquired during sexual relations, usually early in sexual life.
- In most women and men who become infected with HPV, these infections will resolve spontaneously.
- A minority of HPV infections persist; in women this may lead to cervical pre-cancer, which, if not treated, may progress to cancer 10 to 20 years later.
- Women living with HIV are more likely to develop persistent HPV infections at an earlier age and to develop cancer sooner.
- Basic knowledge of women’s pelvic anatomy and the natural history of cervical cancer gives health-care providers at primary and secondary levels the knowledge base to effectively communicate and raise the understanding
of cervical cancer prevention in women, families and communities.
Reasons to focus on cervical cancer
The reasons to focus on cervical cancer include:
- Worldwide, 266 000 women die of cervical cancer each year. It is the leading cause of cancer deaths in Eastern and Central Africa.
- The majority of these deaths can be prevented through universal access to comprehensive cervical cancer prevention and control programmes, which have the potential to reach all girls with human papillomavirus (HPV) vaccination and all women who are at risk with screening and treatment for pre-cancer.
- We know what causes cervical cancer: almost all cases are caused by a persistent (very long-lasting) infection with one or more of the “high-risk” (or oncogenic) types of HPV.
- We understand the natural history of HPV infection and the very slow progression of the disease in immunocompetent women, from normal (healthy) to pre-cancer, to invasive cancer, which is potentially fatal.
- The 10- to 20-year lag between pre-cancer and cancer offers ample opportunity to screen, detect and treat pre-cancer and avoid its progression to cancer. However, immunocompromised women (e.g. those living with HIV) progress more frequently and more quickly to pre-cancer and cancer.
- There are several available and affordable tests that can effectively detect precancer, as well as several affordable treatment options.
- HPV vaccines are now available; if given to all girls before they are sexually active, they can prevent a large portion of cervical cancer.
- Until there is universal access to cervical cancer prevention and control programmes, which will require addressing present inequities, the large disparities in incidence rates and mortality rates that exist in different settings will continue to be ample evidence of lack of comprehensive and effective services.
Global epidemiology of cervical cancer
Epidemiology is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.
Numbers and comparisons between countries
Cervical cancer is the most common cancer among women in 45 countries of the world, and it kills more women than any other form of cancer in 55 countries.
These include many countries in sub-Saharan Africa, many in Asia (including India), and some Central and South American countries.
illustrate global differences in incidence and mortality rates between countries and regions of the world.
These maps do not include the wide disparities in incidence and mortality between areas within specific countries, which are related to socioeconomic and geographic variation, gender bias and culturally determined factors that can all severely restrict access to preventive services among some groups of women.
Further, the following data clearly illustrate the great differences found between women living in high-income versus low- to middle-income countries:
- In 2012, 528 000 new cases of cervical cancer were diagnosed worldwide; of these, a large majority, about 85% occurred in less developed regions.
- In the same year, 266 000 women died of cervical cancer worldwide; almost 9 out of every 10 of these, or 231 000 women in total, lived and died in low- to middleincome countries. In contrast, 35 000, or just 1 out of every 10 of these women, lived and died in high-income countries.
- The main reason for these disparities is the relative lack of effective prevention and early detection and treatment programmes, and the lack of equal access to such programmes. Without these interventions, cervical cancer is usually only detected when it is already at an advanced stage so that it is too late for effective treatment,
and therefore mortality is high. - Changes observed in numbers of cases diagnosed and deaths in the last 30 years Over the last 30 years, cervical cancer incidence and mortality rates have fallen in countries where social and economic status has improved. This is largely a result of the implementation of secondary prevention efforts, which include effective
screening, early diagnosis and treatment for pre-cancer and early cancer.
Female pelvic anatomy and physiology
Why understanding female genital anatomy is important An understanding of the anatomy of the female pelvic structures will help health-care providers involved in cervical cancer programmes to:
- perform their tasks, including community education, screening, diagnosis and treatment of pre-cancer;
- refer women who have lesions that cannot be managed at the provider’s level to appropriate higher-level facilities;
- interpret laboratory and treatment procedure reports and clinical recommendations received from providers at higher levels of the health-care system;
- educate and provide one-on-one counselling to each patient (and her family if she requests this) about her condition and the plan for her follow-up care; and
- communicate effectively with providers at all levels of care, including community health workers and tertiary-level referral providers. See Introduction for descriptions of the different levels of health-care services and the
providers at each level.
Identification of the external and internal organs
The external organs
The external organs include those visible with the naked eye and those visible using a speculum. Figure 1.3 shows the area seen when a woman of reproductive age spreads her legs.
This includes the vulva (the area between the upper border in figure and the level of the Bartholin glands), the perineum and the anus.
The vulva comprises the vaginal opening (introitus), which, with nearby structures, is protected by the major and minor labia.
The clitoris is a small and very sensitive organ that enhances sexual pleasure.
The urinary opening (urethra) is a very small opening above the introitus.
The perineum is the area between the vaginal opening and the anus.
Bartholin glands produce clear mucus which lubricate the introitus when a woman is sexually stimulated.
| Language | English |
| No. of Pages | 408 |
| PDF Size | 5 MB |
| Category | Health |
| Source/Credits | who.int |
Cervical Cancer PDF Free Download