Cervical cancer is the third most common cancer in women worldwide. It can be prevented if Pap smear screening is performed on a regular basis.
In the USA, the incidence of cervical cancer declined drastically due to organized support by the state. Also, women are now more aware of the importance of regular Pap smear screening.
Bosnia and Herzegovina is one of those European countries with high cervical cancer incidence rates due to lack of organized screening state support and low level of awareness of women in their reproductive age about the importance of Pap smears.
Cervical cancer is caused by abnormal cells on the cervix. It is most usually caused by human Papillomavirus (HPV), which inhabits the cells of the cervical epithelium. There are different types of this virus that may cause cervical cancer. Incidence rate is higher with women who became sexually active in their early age, or who have unprotected intercourse, change partners a lot, smokers and patients who, besides the said risks, also use birth control pills.
Pap tests enable a cytologist to determine the cervical abnormality level (low, medium or high) and help in early detection of the cervical cancer, which can then be successfully treated.
A TRUE STORY
A.B. came to us because she thought she had increased vaginal discharge. Pap smear screening was carried out. She came five days later for the test results which indicated medium epithelium abnormality (CIN II). She was suggested a colposcopy. The test results showed changes in the epithelium. A sample of cervical cells was taken and examined to see whether there were any abnormal cells. In two days, PCR screening showed the presence of high risk HPV. The same sample was used for HPV typing, which showed presence of type 16 and 18. These two types of HPV are the main causes of the cervical cancer. Regardless of all findings, we proposed the patient to treat her with the radio wave LLETZ procedure (large loop excision of the transformation zone), which is also known as loop biopsy. This procedure will remove a small segment of your cervix. It is painless, causes no bleeding or blood clotting. It takes only five minutes and no anesthetic is needed. The patient may go home after the procedure is done. Radio wave therapy, compared to other LLETZ methods (heat, laser or freezing) is the least traumatic for patients and it leaves cervix almost unchanged. In this specific case, histopathology of the taken sample showed high risk abnormalities, which this procedure successfully eliminated. After three months, the patient came for her regular examination and Pap smear screening. The results came negative. Six months after the procedure, the patient got pregnant and gave birth to a healthy baby. Currently, she is breast feeding her baby. She comes every six months for her regular Pap smear screening.
The story of this patient is really inspiring. She was so close to get the cervical cancer. Thanks to Pap smear screening, HPV detection and colposcopy, non-invasive radio wave LLETZ procedure was carried out and abnormal cells and a small part of the cervix removed, which led to complete recovery of this patient. Today, she is healthy and happy woman, a mother of a healthy baby.