Generating a greater culture of prevention that encourages vaccination (in women and men), maintaining monogamous relationships, as well as avoiding risky situations, are essential to combat cervical cancer, considered the second most prevalent in our country, says Asucena Iraís Mendoza Huerta, a professor at the UNAM Faculty of Medicine.
The researcher also points out that prevention has shown in first world nations that it is possible to reduce the incidence of cases and deaths from this tumor caused by the human papillomavirus (HPV).
Today, there are tools to combat this problem: Pap smears and vaccinations; so having a day dedicated to this topic is an important reminder for society to understand that this cancer is 100 percent preventable if detected in time.
According to the Ministry of Health, in Mexico since 2006 this disease is the second cause of oncological death in women, after breast cancer, which is why in 2019 the Official Gazette of the Federation published the decree establishing the need to fight against this disease.
In turn, the World Health Organization (WHO) reported that in 2020 this carcinoma had an incidence of 604 thousand new cases per year in the world and was the cause of 342 thousand deaths.
On the occasion of the National Day of the Fight against Cervical Cancer, which is commemorated on August 9, Mendoza Huerta recalls: although there are almost 60 variants of HPV, the highest risk subtypes are 16 and 18, since they cause 70 percent of cervical cancer and bulbar and vaginal cancer, as well as precursor lesions.
The adjunct professor of the Gynecologic Oncology Course at the FM Hospital Juárez recognizes that the problem is that few women go for annual Pap smear checkups for the early detection of lesions in the cervix, or they do not take advantage of the fact that there are currently three types of vaccines to combat the virus.
The gynecologic oncologist says that the issue is that this type of tumor does not generate immediate symptoms; only when it is in advanced stages is it possible to notice bleeding, discharge of foul-smelling fluids and bleeding during or after sexual relations, so it is recommended that especially those aged 25 to 64 who have started their sexual life, undergo tests every year.
The head of the Gynecological Tumor Unit at the Veracruz State Cancer Center also indicates that the objective of screening is to detect lesions in time that usually appear before cancer cells emerge.
Mendoza Huerta explains that it takes approximately one to two years from the onset of infection for a low-grade lesion to appear in the cervix; from then on, it can take up to three more years for a high-grade lesion to appear. It takes four to five more years for the initial cancer to develop. Meanwhile, it can take five to 10 more years for a large tumor to form, which means almost two decades of opportunity for early detection.
Risk factors for developing this type of cancer include starting sexual relations before the age of 18, a history of sexually transmitted diseases or HPV infection, having multiple sexual partners (either the woman or her partner), smoking, malnutrition, as well as problems with the immune system.
The researcher also recalls that since 2018, the WHO has been promoting the 90-70-90 strategy worldwide to reduce cervical cancer, which proposes that 90 percent of patients under 15 years of age be vaccinated, 70 percent of those who have started their sexual life undergo an annual study, and that 90 percent of the lesions found or detected be treated.
Mendoza Huerta explains: the goal is to reduce mortality, including incidence, by 2030. If developed countries have achieved this, we can do it with the same strategy.
Currently, he points out, there are three types of vaccines, of which Cervarix is only available in the public health system and combats HPV serotypes 16 and 18; Gardasil, 6, 11, 16 and 18, and is offered privately. As of 2023, the use of nonavalent Gardasil was approved in Mexico, which combats up to nine variants of the virus (6, 11, 16, 18, 31, 33, 45, 52 and 58); it is also available in the private sector.
For the university researcher, although vaccination is recommended primarily for women due to the development of cancer, it is ideal for men from the age of nine, since even though they do not present symptoms, they are carriers of HPV.
