19-year-old girl suffers from cervical cancer, expert： premature sex can induce cancer.

Xiao Xie (pseudonym), a migrant worker, was diagnosed with cervical cancer after going to the hospital for examination due to an increase in leucorrhea. At the age of 19, she felt incredible.

Speaking of cervical cancer, you will not be too unfamiliar. Famous singer Anita Mui and movie star Li Yuanyuan all died of this disease. It is one of the most common gynecological malignant tumors. With the decrease of the age of sexual behavior, the incidence of cervical cancer has also shown the characteristics of younger age in recent years. Then why does premature sex induce cervical cancer? How to achieve early detection and treatment of cervical cancer?

The more sex, the higher the risk.

Ding Jingxin, deputy chief physician of Gynecology Department of Obstetrics and Gynecology Hospital affiliated to Fudan University, pointed out that the cause of cervical cancer has been clearly diagnosed, that is, HPV infection. The high incidence of cervical intraepithelial neoplasia (CIN) is 25-35 years old. Invasive cancer is 50-55 years old, and its incidence has a trend of younger in recent years.

25-35-year-old women are generally under great pressure. In addition, with the increase of age, their resistance gradually deteriorates, which reduces the ability to remove HPV virus. Once infected with HPV virus, it may cause persistent infection of the virus, and finally lead to precancerous lesions or cervical cancer.

In addition, early delivery, multiple pregnancy and prolificacy are closely related to the occurrence of cervical cancer, and smoking as a synergistic factor of HPV infection can increase the risk of cervical cancer.

In particular, it should be pointed out that the recognized causes of cervical cancer mainly include premature sexual intercourse (under 18 years old), HPV infection caused by multiple sexual partners, repeated uterine cervix operations, malnutrition and so on. It is understood that the rejuvenation of cancer is closely related to the early start of sexual life and the unclean process. The younger the age of first sexual intercourse, the more sexual partners and the more frequent sexual intercourse, the higher the incidence rate.

"This is because the cervical tissue cells of young girls are not fully developed, and their ability to resist diseases is poor. They are sensitive to external carcinogens and cancer-promoting substances and are easily stimulated by carcinogenic factors. After adulthood, the female reproductive defense system gradually matures, and then it begins to have normal disease resistance. If sexual intercourse is started when it is not mature, and the sexual partner is an HPV carrier, it is easy to infect HPV through sexual intercourse, and continuous infection induces cancer. " Dr. Ding Jingxin said. "For women, not having sex too early and reducing sexual partners may be a way to prevent cervical cancer. In addition, HPV vaccine can also be used to prevent diseases, and regular screening can also help patients achieve early detection and early treatment. "

Some studies have also pointed out that the sexual behavior of male partners is also closely related to cervical cancer. Comparing the characteristics of sexual behavior and other behaviors of spouses of cervical cancer and healthy women, and studying the role of men in the pathogenesis of cervical cancer, it is pointed out that the number of sexual partners of spouses of cervical cancer is far more than that of spouses of control group, and most of the spouses of cervical cancer have sexual history, such as genital herpes, gonorrhea and genital warts, while women whose spouses often use condoms have low risk of cervical cancer. In addition, it is also found that the risk of cervical cancer in men’s wives is 3-6 times higher than that in normal women.

"For a woman infected with HPV, her male partner may become a carrier of HPV virus. For new sexual partners, the use of condoms will reduce the chance of contracting the virus. " Dr. Ding Jingxin said.

How to prevent cervical cancer

Dr. Ding Jingxin said that every year, more than half of the outpatients with cervical cancer found that they had reached the middle and late stage, and lost the best treatment opportunity, which was life-threatening.

Cervical cancer is the most common gynecological malignant tumor. Cytological screening and HPV screening enable early detection and treatment of cervical cancer and precancerous lesions, which is of great significance to prevent cervical cancer.

So what are the symptoms of cervical cancer?

Vaginal bleeding: mostly contact bleeding, it can be irregular vaginal bleeding, or it can be manifested as prolonged menstrual period and increased menstrual flow; Elderly patients often suffer from irregular vaginal bleeding after menopause.

Vaginal drainage: most patients have vaginal drainage, the liquid is white or bloody, which can be as thin as water or rice, or has a foul smell.

Late symptoms: different secondary symptoms appear according to the extent of cancer involvement. When cancer oppresses or involves ureter, it can cause ureteral obstruction, hydronephrosis and uremia; There may be anemia, cachexia and other symptoms of systemic failure in the late stage.

How to screen cervical cancer? According to the 2016 ACOG Practice Guide No.157 on Cervical Cancer Screening and Prevention, cervical cancer screening is mainly based on liquid-based cytology screening TCT/LCT or HPV screening.

Cervical cancer screening should start at the age of 21. Single-line cytological screening for people aged 21-29, once every three years.

It is best for people aged 30-65 to have cytology and +HPV combined screening every five years. Cytological screening once every three years is acceptable.

Those who have enough negative screening results in the past and have no CIN2+ lesions should stop any kind of screening after the age of 65. Adequate negative screening results are defined as three consecutive cytological negative results or two consecutive combined negative screening results in the past 10 years, and the last screening is within 5 years.

Routine cytological screening and HPV detection should be terminated in patients who have undergone total hysterectomy and have no CIN2+ lesions in the past.

Women with CIN2, CIN3 or adenocarcinoma in situ should continue to be screened for 20 years after spontaneous regression of the lesion or proper treatment, even if the screening period will exceed 65 years.

For women aged 25 and above, the initial screening with the HPV detection method approved by FDA can be considered as an alternative to the current cytological screening method. Cytological screening alone and combined screening are still recommended measures in the guidelines of major professional associations. If HPV testing is used as a separate screening, it should follow the transition guidelines of American Society of Colposcopy and Cervical Pathology (ASCCP).

The risk of CIN in people whose cytology is ASC-US and HPV is negative (whether it is the follow-up HPV test or the combined HPV test) is lower, but it is slightly higher than that in people with negative combined screening. It is recommended to combine screening again after 3 years.

So as long as HPV infection is detected, does it mean that you will get cervical cancer? Dr. Ding Jingxin pointed out that it is best to make a virus typing for people infected with HPV. One quarter to one third of those infected with HPV16 may develop into cervical high intraepithelial neoplasia (HSIL) and cervical cancer within three years, and 10% of those infected with HPV18 may develop into cervical high intraepithelial neoplasia (HSIL) and cervical cancer within three years, while only 5% of those infected with other 12 viruses will be infected.

"Therefore, for those infected with HPV16 and 18 viruses, colposcopy should be done every year, and for other types of infected people, TCT screening can be done regularly." Dr. Ding Jingxin said, "It should be pointed out that women should not worry too much if they are infected with HPV. It takes 9-25 years to develop from HPV infection to cervical cancer. 70% ~ 80% of women will be infected with HPV in their lifetime. HPV can be eliminated by your own immune system. It is not terrible to be infected with HPV. Only the diagnosis of cervical intraepithelial neoplasia (CIN) and cervical cancer needs treatment. "

The best time for vaccination

Dr. Ding Jingxin pointed out that HPV vaccination is also a very important means for the prevention of cervical cancer. HPV vaccine is the first vaccine against tumor in the world. Because sexual transmission is the main route of HPV infection, the best time for HPV vaccination is before sexual intercourse.

"The World Health Organization recommends that the golden age of HPV vaccination is boys and girls aged 9-13 who have not started sex." Dr. Ding Jingxin said, "Women who have already had sex can also be vaccinated, but the protective effect of the vaccine may be discounted. There are many kinds of HPV viruses that cause cervical cancer. Even if you are vaccinated with HPV vaccine, you can’t completely prevent the occurrence of cervical cancer. Women who are vaccinated still need regular screening. "