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Cervical cancer is a malignant tumor that develops in the cells of the cervix, the area where the uterus connects to the vagina.

It usually begins with precancerous changes in the cells of the surface of the cervix, which are often referred to as dysplasia or “cervical intraepithelial neoplasia” (CIN). These changes can remain stable for a long time or, if not diagnosed and treated early, develop into invasive cancer. This development is usually slow, which makes preventive examinations (Pap smear and HPV testing) effective.

Cervical cancer is the fourth most common cancer in women worldwide. In developing countries, where screening programs and vaccination against HPV are not systematically implemented, it remains the most common gynecological cancer. It is also the leading cause of death in young women. According to data from the USA, in 2019 it was the second leading cause of death from cancer in women aged 20 to 39.

What are the risk factors for developing cervical cancer?

The human papillomavirus (HPV) is responsible for an overwhelming percentage (about 98%) of the occurrence of cervical cancer. HPV is a group of more than 200 related viruses, of which about 40 are most often transmitted through sexual contact, affecting the genital area. HPV genotypes 16 and 18 are responsible for approximately 70% of cervical cancer cases and are considered the most common high-risk HPV genotypes. Low-risk HPV genotypes are usually associated with benign hyperplastic lesions or genital warts.

Are there any symptoms that can help us recognize its presence?

In most cases, cervical cancer remains asymptomatic in the early stages. However, some possible symptoms include:

• Vaginal bleeding after sexual intercourse

• Unusual vaginal discharge

Early diagnosis through preventive tests (Pap smear test, HPV test) is particularly important, because it leads to more effective treatment and a better prognosis.

Can prevention save us from cervical cancer?

Prevention has been shown to significantly reduce the incidence of the disease. According to international guidelines, in women over 30 years of age, in addition to the Pap test, testing for HPV is also recommended. In younger women, testing for HPV is not considered necessary, because a positive result may cause psychological distress without providing essential clinical information.

In the event of pathological findings, further treatment (conservative monitoring or colposcopy) is decided based on the patient’s history, age and family situation. This decision should be made by specialized and experienced gynecologists, given that treatment algorithms are becoming increasingly complex.

At the same time, vaccination against HPV, preferably at a young age, has proven to be highly effective in preventing HPV-related cancers. Specifically, a reduction in infection with HPV 16 and 18 of up to 83% has been recorded in girls aged 15-19 years and up to 66% in women aged 20-24 years, within 5-8 years of the introduction of vaccination.

What is the modern treatment of cervical cancer?

A basic requirement for the correct treatment of cervical cancer is the design of an individualized plan by specialized gynecological oncologists. In a modern oncology center such as the Inter-Balkan Medical Center of Thessaloniki, all available surgical techniques (laparoscopic, open and robotic surgery) are applied, while the decision for surgery or chemoradiotherapy is determined by the stage of the disease, with the main goal of achieving the best oncological outcome.

Of particular importance is the use of specialized surgical techniques, such as nerve sparing radical hysterectomy, which protects specific nerves and helps to avoid postoperative dysfunctions of the bladder and colon. Furthermore, in some cases, the application of the sentinel lymph node technique can reduce the need for radical lymphadenectomy and its possible complications.

For patients diagnosed in the early stages and meeting specific under certain conditions, it is possible to preserve the uterus and fertility by performing a radical cervicectomy.

All of the above procedures require specialization, significant surgical experience, and a multidisciplinary approach to ensure the best possible outcome for the patient.