January is Cervical Cancer Awareness Month

January is a month of reminder about cervical cancer, which is one of the most common and dangerous types of cancer in women. According to the National Cancer Registry, cervical cancer is diagnosed in about 3,000 women in Ukraine every year. Mortality from this disease in women aged 18–29 years ranks first, and in women aged 30–54 years — second among the causes of death from malignant neoplasms in women.

However, there are effective ways to prevent this disease, and in case of early detection, it is well treatable even with organ preservation.

From January 1, 2025, in Ukraine, by Order of the Ministry of Health of Ukraine No. 1368 dated August 5, 2024, “On ensuring screening and early diagnosis of certain types of cancer and monitoring the health of patients from risk groups,” a procedure for screening and early diagnosis of cervical cancer has been introduced.

Most cases of cervical cancer are associated with infection with high-risk human papillomavirus (HPV), which is extremely common and most often transmitted during sexual contact. Most women and men become infected with HPV shortly after the onset of sexual activity, and under unfavorable conditions, HPV can persist in the epithelial cells of the cervix, causing transformational effects on the cell nucleus, leading to dysplasia and cervical cancer. Cervical cancer may not show any symptoms for a long time, and signs such as changes in vaginal discharge, irregular bleeding or pain and bleeding during intercourse, pelvic pain are already late symptoms (“death symptoms”).

Risk factors for cervical cancer include infection with high-risk HPV, smoking, early onset of sexual activity and a large number of sexual partners, the presence of high-risk partners, as well as sexually transmitted infections, lack of barrier contraception, immunodeficiency states (HIV/AIDS, etc.).

The screening and early diagnosis system provides for primary and secondary prevention. Primary prevention should include active educational work, talking about factors that may increase the risk of cervical cancer among vulnerable groups of the population (adolescents, people with immunosuppression, low socio-economic status, with multiple sexual partners, unprotected sexual intercourse). Primary prevention also includes vaccination of girls (and, if desired, boys) aged 9–14 years with the HPV vaccine before the onset of sexual activity (although vaccination of women and men under 45 years of age is possible). Secondary prevention involves an annual examination by a family doctor and a gynecologist, mandatory diagnostic tests: regular high-efficiency screening (PAP test, HPV test, co-testing) at recommended intervals, timely diagnosis and treatment of precancerous diseases and cervical cancer. Vaccination in 90% of cases protects against the development of such types of cancer as cervical cancer, oral cavity and throat, genitals and anus.

Issues of oncogynecology, early diagnosis and treatment of precancer and early cervical cancer are priority areas of scientific and medical work of the Department of Obstetrics and Gynecology of ONMedU, initially under the leadership of Academician of the National Academy of Medical Sciences of Ukraine V. M. Zaporozhan, who developed the problems of treating precancerous cervical pathology and received state awards for a series of works, currently under the leadership of Professor I. Z. Gladchuk. Professors of the Department (V. V. Artiomenko, N. M. Rozhkovska) are co-developers of the evidence-based clinical guideline and the national standard of medical care “Cervical cancer screening. Management of women with abnormal screening results and precancerous cervical conditions” (Order of the Ministry of Health of Ukraine No. 1057 dated June 18, 2024). The department has scientific and practical cooperation with the National Cancer Institute, the Ukrainian Association of Oncologists, the Ukrainian Association of Colposcopy and Cervical Pathology, specialized departments of universities in Ukraine and Europe, participated in clinical studies on the development of a therapeutic vaccine against the human papillomavirus, conducts thematic improvement courses “Modern methods of diagnosis and treatment of cervical pathology. Colposcopy” for doctors of Odesa region, as well as consultative receptions in ONMedU clinics. The staff of the department present their scientific developments on the application of the latest surgical technologies in the treatment of early stages of cervical cancer using the labeling of signal lymph nodes with indocyanine green, at international congresses of the European Association of Gynecological Oncologists (Istanbul, 2023, Barcelona, ​​2024), the European Association of Gynecological Endoscopists (Marseille, 2024), etc., with publications in international index-cited publications (Scopus, Wed of Science). The educational, scientific, consultative and therapeutic work of the Department of Obstetrics and Gynecology contributes to increasing the awareness of the population and the adherence of women to preventive examinations and vaccination, which will reduce the incidence and mortality from cervical cancer.