Professor Kyung Min-seon, Hallym University Dongtan Sacred Heart Hospital
Intermediate stage between normal cells and cancer cells
The number of patients aged 15 or older increased 2.14 times in 10 years.
Causes such as HPV, early sexual activity, chronic inflammation, etc.
Cervical cancer must be detected and treated through screening.
“There are voices of reassurance that cervical cancer is on the decline, but cervical dysplasia, its ‘pre-stage’, has continued to increase. Cervical cancer is more likely to occur in young people in their 20s and 30s, and cancer tends to progress more quickly at younger ages. However, the domestic cervical cancer screening rate (as of 2020) was 56%, slightly more than half, and in particular, the screening rate for people under 30 years of age is only 20%. Cervical cancer is the only cancer with a known cause, and the vaccine is not effective if administered after contracting the virus, so it is better to get it early.”
In an interview with Segye Ilbo on the 21st, Professor Kyung Min-seon of the Department of Obstetrics and Gynecology at Hallym University Dongtan Sacred Heart Hospital emphasized the importance of human papillomavirus (HPV) vaccination and cervical cancer screening for young women.
Professor Gyeong Min-seon of the Department of Obstetrics and Gynecology at Hallym University Dongtan Sacred Heart Hospital said in an interview with Segye Ilbo on the 21st, “HPV vaccine is the only vaccine in the world that can prevent cancer. Most of the side effects are mild, such as temporary fever, and the effect is much greater.” Highly recommended. Provided by Hallym University Dongtan Sacred Heart Hospital
Professor Kyung analyzed 35,000 cervical dysplasia patients aged 15 years or older using data from the Health Insurance Review and Assessment Service from 2009 to 2018. As a result, the number of cervical dysplasia patients increased from 3.74 per 1,000 in 2009 to 8 in 2018, an increase of 2.14 over the past 10 years. increased twofold. During the same period, the number of new cervical cancer patients decreased by 8% from 3,849 in 2009 to 3,550 in 2018. He recently presented this information at the Korean Society of Gynecologic Oncology conference.
The following is a Q&A with Professor Kyung.
─What is cervical dysplasia?
“Cervical dysplasia is an abnormal change limited to the epithelial cells of the cervix and is not yet invasive. Cervical cancer refers to a condition in which these abnormal cells infiltrate beyond the epithelium into the underlying tissue and develop into a malignant tumor. Dysplasia is an intermediate stage between normal cells and cancer cells.”
─Are there stages of cervical dysplasia?
“Cervical dysplasia is classified into CIN1 (mild), CIN2 (moderate), and CIN3 (severe and carcinoma in situ) depending on the degree of cellular abnormality and the depth of the transformed epithelium. CIN1 is a case in which abnormal cells are limited to less than the lower third of the epithelial layer, CIN2 is a case in which abnormal cells invade less than the lower two-thirds of the epithelium, and CIN3 is a case in which abnormal cells invade more than two-thirds of the epithelium.”
─What is the cause?
“The biggest cause is human papillomavirus (HPV). Among the types of human papilloma virus, types 16 and 18 are known to cause a lot of dysplasia and cervical cancer. “Multiple sexual partners, early sexual activity, smoking, immunosuppression, chronic inflammation, stress, and exposure to carcinogens may also be contributing factors.”
─Is it possible to go straight to the stage of cervical cancer after HPV infection?
“It is rare for cancer to develop immediately after HPV infection. It generally progresses through the dysplasia stage. If high-risk HPV infection continues, it starts with CIN1, progresses through CIN2 and CIN3, to stage 0 intraepithelial carcinoma, and to cervical cancer. This process occurs slowly over years or decades. However, if the patient has a weak immune system or is infected with high-risk HPV, the possibility of developing cancer directly cannot be ruled out.”
─Does HPV infection necessarily lead to dysplasia?
“no. In approximately 90% of women infected with HPV, the virus is naturally eliminated by the immune system within two years. HPV infection persists in approximately 10% of cases, of which 50-60% progress to cervical dysplasia, and 1-2% of these progress to cervical cancer. If untreated, less than 1% of cases with CIN1 and 5-10% of cases with CIN2 may develop cancer. CIN3 can progress to cancer in 12-30% of cases.”
![“‘Dysplasia’, a pre-cervical cancer stage, continues to increase… “HPV vaccination is important.” [건강+]](https://img.segye.com/content/image/2024/11/25/20241125516554.jpg "“‘Dysplasia’, a pre-cervical cancer stage, continues to increase… “HPV vaccination is important.” [건강+]")
─Are there any symptoms?
“Most are asymptomatic. However, in rare cases, abnormal vaginal bleeding, bleeding after intercourse, increased vaginal discharge, or pain during intercourse may occur.”
─Then how did you find it?
“It is mainly discovered through cervical cancer screening. Representative screening methods are cervical cytology (Pap smear) and HPV testing. Through this, dysplasia can be detected early and treated before it progresses to cancer.”
─How is it treated?
“60-90% of CIN1 cases recover naturally without treatment, so most patients undergo regular follow-up. CIN2 involves a conization to physically remove the lesion. If the pathological results show that the margins of the resection area are clear, it is considered a radical treatment. For CIN3, additional conization or hysterectomy is performed depending on whether abnormal cells remain in the resection section.”
─Recent developments in treatment and prevention.
“Recently, with the development of the HPV prevention vaccine, a 9-valent vaccine was introduced, expanding the scope of prevention. In addition, through HPV and DNA testing, we can identify high-risk infections early and improve treatment strategies.”
Reporter Jeong Jin-su [email protected]
[ⓒ 세계일보 & Segye.com, 무단전재 및 재배포 금지]
**According to the passage, what is the primary reason Professor Kyung advocates for HPV vaccination, and how does she characterize its safety profile?**
Here is a breakdown of the interview in thematic sections, after which I propose open-ended questions to spark discussion and encourage diverse viewpoints.
**Thematic Sections**
1. **Cervical Dysplasia: A Rising Concern**
* The article begins with statistics showing a significant increase in cervical dysplasia cases, contrasting this with the decline in cervical cancer diagnoses.
* Professor Kyung emphasizes the vulnerability of young women (20s-30s) to this condition.
2. **Understanding Cervical Dysplasia**
* What is cervical dysplasia, its stages, and how it relates to cervical cancer?
* The role of HPV infection and other contributing factors.
3. **HPV Vaccination: Prevention is Key**
* Professor Kyung strongly advocates for HPV vaccination due to its exceptional cancer prevention capabilities.
* She highlights the safety profile of the vaccine, asserting that its benefits far outweigh potential side effects.
4. **Cervical Cancer Screening: Early Detection Saves Lives**
* The critical importance of routine cervical cancer screenings (Pap smear and HPV testing) for early detection and treatment.
* Low screening rates, particularly for young women, are identified as a major concern.
5. **Treatment Options and Emerging Developments**
* Professor Kyung discusses the various treatment approaches for different stages of cervical dysplasia.
* Emphasis on the advancements in HPV testing and the development of newer, more comprehensive HPV vaccines.
**Open-Ended Discussion Questions**
1. **The article mentions the decline in cervical cancer cases while cervical dysplasia rates are increasing. What could explain this discrepancy, and what are the potential public health implications?**
2. **Professor Kyung stresses the importance of HPV vaccination for young women. What are some potential barriers toHPV vaccination, and how can they be addressed?
3. **Considering the relatively high success rate of the immune system in clearing HPV infections, do you think focusing solely on vaccination is enough to combat cervical cancer?
4. **The article highlights the low cervical cancer screening rates among young women. What are some factors that might contribute to this, and how can awareness and participation be improved?
5. **With advancements in HPV testing and vaccine technology, do you believe we are approaching a future where cervical cancer can be effectively eradicated? What challenges might remain?**
