In recent decades, the incidence of cancer has risen significantly in all developed countries around the world. Cervical cancer is still a significant public health problem today. Cervical cancer is the fourth most common cause of cancer-related mortality in Hungary.
The incidence of cervical cancer is uneven across the world, with significant differences in economic development; human papillomavirus (HPV) infection is a risk factor for its development.
During cervical screening, the condition of the lower part of the uterus, the cervix is checked. During a Pap smear, a small amount of cell sample is taken from the surface of the cervix, and then cytologists look for changes in the cells. Screening is recommended to be performed between 10 and 22 days after the first day of your period.
The purpose of cervical screening:
- Preventing cervical cancer by recognizing the asymptomatic pre-cancerous condition of the cervix. If patients are started on treatment at this stage, the lesion will not progress into cancer.
- Reducing cervical cancer mortality by early detection and treatment of cervical cancer that is still asymptomatic.
Therefore, it is important to participate in regular cervical screening.
Screening can save lives!
HPV and cervical cancer
Harald Zur-Hausen's experiments confirmed the causal link between HPV infection and cervical cancer development, for which he was awarded the Nobel Prize in 2008. Recognizing the role of HPV in cervical cancer development has opened up two new possibilities to achieve public health goals:
- regarding primary prevention by the introduction of HPV vaccination;
- regarding secondary prevention by sampling and laboratory testing for HPV infection.
As the result of viral infection, the cells that make up the cervix begin to grow abnormally. About 140 different types of HPV are known, of which approximately 15 can cause cervical cancer. According to medical literature, two oncogenic virus types (the so-called 16 and 18) together are responsible for more than 70% of all cervical cancer cases worldwide.
HPV is very common: it is estimated that at least 80% of women become infected during their life and an oncogenic virus cause 50% of the infections. Fortunately, most infections go away on their own within 1-2 years, but if the infection persists or re-infection happens, the risk of developing cervical cancer significantly increases. Prolonged infection caused by an oncogenic type can lead to abnormal and pre-cancerous changes in the cells of the cervix, which can transform into a malignant tumor over time.
HPV infection in men
HPV is not only a threat to women, men can also easily become infected. In most cases, the carriers of the virus are men, who, although often asymptomatic, can pass the infection on to their female partners during sexual intercourse. Therefore, the monitoring of male partners may be required in case of HPV-infected women. In addition, HPV also increases the risk of diseases in men in the long run (see below).
Diseases caused by HPV
HPV infection is often asymptomatic, especially at a younger age and goes away on its own. In some cases, however, the virus persists and can cause cervix, labia, vagina, penis, anus, mouth, throat, tongue and larynx cancer over time.
Important! If you notice any unusual symptoms or abnormalities related to menstruation, contact your GP or gynecologist immediately.
Cervical screening in Hungary
Targeted (organized) cervical screening for public health purposes started in 2003 in Hungary. Screening is performed according to the method adopted by the World Health Organization (WHO). Women between the age of 25 and 65 will receive an invitation letter for cervical screening every 3 years following a one-time negative Pap smear. Until 2009, screening was performed only by gynecologists in outpatient clinics, in contrast to the method used in most European countries, where screening is the responsibility of trained nurses.
In order to increase the number of screened women, the availability of Pap tests (provided that certain conditions are met) from 1 October 2015, is also ensured within the framework of the local district health-visitor system. Cytological examination of Pap smears taken by health visitors or gynecologists is performed in cytopathological laboratories.
Eligibility for cervical screening
Any woman between the age of 25 and 65 with valid social security who has not participated in cervical screening or in diagnostic gynecological examination for 3 years (exactly 34 months) and has no diagnosed cervical cancer can be invited for cervical screening.
How to participate in cervical screening?
Those eligible for screening will receive an invitation letter by mail during the 3-year screening cycle. The sampling (Pap smear) required for screening can be performed by:
The gynecologist of the gynecological clinic chosen by the woman or the local district health visitor (further information see: Health-visitor services) if the healthcare provider who employs her has an operating license and a financing contract to perform the task.
The contact information of the health-visitor, as well as the address and contact details of the gynecological clinics performing the screening near the place of your residence are included in the invitation letter.
Primary prevention of cervical cancer is provided by vaccination against HPV. Vaccination can prevent HPV from infecting the body, as the vaccine will allow the immune system to produce antibodies if the virus appears. From 2015, parents of 7th grade girls and from September 2020, parents of 7th grade boys can ask for HPV vaccination, free of charge.
Vaccination and regular cervical screening together are the best way to fight cervical cancer. Neither vaccination nor cervical screening alone is sufficient for effective and efficient prevention. Therefore, regular cervical screening is required even after vaccination.