Cervical cancer is a disease that can be prevented, and Montenegro, along with the less developed countries of the world, still records a large number of cases of the disease, more and more often in the population of women under 40 years of age.
This was said by a specialist in gynecology and obstetrics, subspecialist in oncology, dr. Vesna Colaković Popović.
"I always like to remember the words of my professor, who said that if we want to find out how much a society takes care of its women, we only need to ask what is the frequency of contracting and dying from cervical cancer. In Montenegro, it is already 12:XNUMX when it comes to this disease. But it is important to start. Some people have been educated and know a lot about how and in what way to fight this disease. They need an opportunity and support", said the doctor.
The disease is most often detected in an advanced stage
Dr. Čolaković Popović said that cervical cancer in the female population at the global level is in fourth place in terms of the frequency of illness and death.
"We can freely say today that it is a disease in which 85 percent of new cases occur in less developed countries of the world. In developed countries, it has not even been among the top ten most common malignancies for a long time. The highest incidence rates are in the countries of Africa, South and Central Asia, South America and Eastern Europe, more than 20 patients per 100.000 inhabitants. Standardized incidence rates for developed countries are less than 10 patients per 100.000 inhabitants, while Finland, Greece and Malta have less than five patients per 100.000", she pointed out.
Dr. Čolaković Popović says that, according to data from the World Health Organization (WHO) for the European continent, Montenegro ranks infamously first in terms of getting sick and dying from cervical cancer.
"Unfortunately, in our country, in two thirds of newly discovered cases, the disease is discovered in an inoperable, advanced stage. The oldest registered patient was 88 years old, and the youngest was 23. In our population, it is a disease that affects women between the ages of 45 and 65, but the disease threshold dangerously drops to the reproductive age below 40 years old," explains the doctor.
A preventable cancer
According to Dr. Čolaković Popović, there are over 200 types of human papillomavirus, while only about forty have the potential to cause cancer.
"Back in the seventies Harald zur Hausen "discovered the causal connection between HPV and cervical cancer and later received the Nobel Prize for that discovery," says the doctor.
He explains that the causative agents of cervical cancer, as well as almost 50 percent of vulva and vaginal cancers in women, are highly oncogenic HPV virus types 16,18, 31, 33, 45, 52, 58, XNUMX...
Those types, he claims, are associated with the occurrence of some types of penile cancer in men, as well as of the anus and oropharynx in both sexes.
"However, the existence of HPV infection is not a sufficient condition for the occurrence of cervical cancer, but the existence of other risk factors that act over time are also important: early sexual intercourse, promiscuous behavior, multiparity, immune compromise, taking oral contraceptives, smoking..." , emphasized Čolaković Popović.
She explained that it is a disease that can be prevented, which the developed world has long since accepted and applied.
"Prevention is the easiest way to health. I like to add - and the cheapest for any health system. Australia officially announced that primary and secondary prevention bring good results with this disease: they introduced vaccination (primary prevention) to their successful screening program (secondary prevention) back in 2006 and announced that they have almost eliminated cervical cancer. The incidence of this disease among them is now 1/100.000", said the doctor.
She reminded that the WHO and the European Association of Gynecological Oncologists invited all countries to join their initiative to reduce the incidence and mortality from cervical cancer, forcing vaccination and organized screening programs.
How often to see a gynecologist?
The doctor replied that the cervix is a part of the organ that is easily accessible for examination, while the examination is non-invasive and painless.
"It is necessary to visit a gynecologist once a year, unless the gynecologist thinks that the examinations should be every six months. More often than not, it makes no medical sense. The examination always includes a PA smear and possibly a colposcopy. Please do not mix regular examinations with the screening examination, which is done by invitation and if the screening test is negative, it is not repeated for five years", she explained.
Dr. Čolaković Popović also assessed that significant results were recorded from the vaccination against HPV, which began in September 2022.
"The screening was started even before the covid pandemic and with the pandemic it was stopped. The problem is that it never got the comprehensiveness of the target population, nor a good response. As long as this is the case, there will be no screening results at the national level," concluded the doctor.
113 women became ill, and 54 died
The Institute for Public Health responded to the "News" that 2020 women died of cervical cancer in 54 and that Montenegro was in first place among European countries in terms of mortality from this malignancy that year.
"It is estimated that in 2020, 113 new women fell ill with cervical cancer. According to the number of cancer patients among women in the same year, cervical cancer was in fourth place.
In relation to the ASIR (age standardized incidence rate), that year, Montenegro was in first place in Europe for this type of cancer," the Institute's reply states.
They explained that the estimates were made without taking into account the introduction of the National Organized Cervical Cancer Screening Program in Montenegro.
"This means that the estimates are underestimated, provided that the Program functions well. Namely, after the introduction of such a public health intervention, a greater number of new (discovered) cases of the disease is always expected.
Also, estimates were made on the basis of authentic data from the Register. As the Register does not have data for recent calendar years, we are forced to use estimated data", said the Institute.
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