SCREENING FOR CERVICAL CANCER

Dr Kiranmai Gottapu

Consultant Obstetrician & Gynecologist

Apollo Tsev Kho Mob, Vishakhapatnam

thiab

Dr Tholapi Kalyani

Obstetrics thiab Gynaecology, Hyderabad

Txheej txheem cej luam

Tom qab lub mis mob cancer, mob khees xaws ncauj tsev menyuam yog suav tias yog mob qog noj ntshav thib ob ntawm cov poj niam. Nws yog thawj qhov ua rau muaj mob qog noj ntshav hauv cov tebchaws tsim kho. Ib tug poj niam twg uas tau ua kev sib deev muaj kev pheej hmoo ntawm kev loj hlob kabmob kheesxaws ncauj tsev menyuam, tab sis ua kev sib deev thaum muaj hnub nyoog yau tuaj yeem ua rau muaj kev pheej hmoo mob qog noj ntshav.

Lub hnub nyoog nruab nrab ntawm kev mob qog noj ntshav hauv tsev menyuam yog 47 xyoo, thiab kev faib tawm ntawm cov neeg mob yog bimodal, nrog rau qhov siab tshaj plaws thaum muaj hnub nyoog 35 txog 39 xyoo thiab hnub nyoog 60 txog 64 xyoo, tshwj xeeb tshaj yog cov neeg uas muaj kev lag luam qis dua vim tsis muaj kev tshuaj ntsuam xyuas txaus. .

Cervical Cancer yog dab tsi?

Cervical Cancer yog ib hom mob qog noj ntshav uas tshwm sim hauv lub ncauj tsev menyuam. Lub ncauj tsev menyuam yog qhov qis ntawm lub tsev menyuam, uas txuas rau qhov chaw mos. Human Papillomavirus (HPV), ib pawg ntawm ntau dua 150 tus kab mob ntsig txog, yog qhov muaj feem pheej hmoo rau mob qog noj ntshav. Ntau yam sib txawv ntawm HPV tuaj yeem kis tau rau lub ncauj tsev menyuam, thiab qee lub hlwb tuaj yeem ua mob qog noj ntshav.

Txoj kev pheej hmoo ntawm kev loj hlob kabmob kheesxaws ncauj tsev menyuam tuaj yeem txo tau los ntawm kev kuaj xyuas tsis tu ncua. Tsis tas li ntawd, kev txhaj tshuaj tiv thaiv kab mob HPV tuaj yeem txo qhov kev pheej hmoo ntawm mob qog noj ntshav thiab lwm yam mob qog noj ntshav.

Human Papillomavirus (HPV) Infection

HPV yog lub ntsiab ua rau feem ntau hom mob qog noj ntshav. HPV tuaj yeem kis tau los ntawm cov tawv nqaij ze rau ntawm daim tawv nqaij, feem ntau thaum muaj kev sib deev. Feem ntau ntawm cov neeg muaj kev sib deev tau ntsib nrog HPV thaum lawv lub neej. Txawm li cas los xij, rau ntau tus kab mob no ua rau tsis muaj kev phom sij thiab feem ntau ploj mus ntawm nws tus kheej.

Txawm li cas los xij, qee hom HPV ua rau qhov chaw mos, thaum lwm tus tuaj yeem ua rau muaj kev hloov pauv uas tuaj yeem ua rau mob qog noj ntshav. Sib nrug los ntawm kev mob qog noj ntshav ntawm lub ncauj tsev menyuam, HPV tuaj yeem ua rau qhov chaw mos, qhov quav, qhov quav, qhov quav, nrog rau qee hom qog nqaij hlav hauv caj pas thiab qhov ncauj.

Hom HPV:

Hais txog 12 hom HPV tau hais tias muaj kev pheej hmoo siab rau mob qog noj ntshav ntawm lub ncauj tsev menyuam, ob hom, HPV 16 thiab HPV 18, ua rau 70% mob qog noj ntshav. Nyob rau lub sijhawm, kwv yees li 5.0% ntawm cov poj niam nyob rau hauv cov pej xeem sawv daws yuav tsum tau muaj tus kab mob HPV-16/18 hauv ncauj tsev menyuam. Tsis tas li ntawd, 83.2% ntawm cov qog nqaij hlav hauv tsev menyuam tau hais tias raug ntaus nqi rau HPVs 16/18.

Cov tsos mob ntawm ncauj tsev menyuam

Qhov chaw mos los ntshav yog cov tsos mob tshaj plaws. Feem ntau, qhov no yog postcoital los ntshav, tab sis nws yuav tshwm sim raws li tsis xwm yeem los yog postmenopausal los ntshav. Cov neeg mob uas muaj tus kab mob siab heev tuaj yeem tshwm sim nrog malodorous pojniam tawm paum, poob phaus lossis obstructive uropathy.

Risk Factors for Cervical Cancer

Kev pheej hmoo rau mob qog noj ntshav yog:

• Kev sib deev thaum ntxov (Sex thaum muaj hnub nyoog ntxov)
• Ntau tus khub sib deev
• Siab ncaj ncees
• Kev siv tshuaj tiv thaiv ntev ntev
• Haiv neeg
• Tsawg socieconomic xwm txheej
• Kev tu cev tsis tshua huv
• Haus luam yeeb
• Chronic immune suppression (lub cev tsis muaj zog)

Cervical Cancer Screening

Tsis zoo li lwm qhov chaw mob qog noj ntshav, lub ncauj tsev menyuam tuaj yeem raug kuaj xyuas thaum ntxov. Qhov muaj feem thiab ntev ntawm kev ciaj sia yuav zoo dua yog tias kuaj pom thiab kho nyob rau theem ua ntej. Niaj hnub nimno radiographic modalities, xws li CT (Computed Tomography) scan, MRI (Magnetic Resonance Imaging), Ultrasound lossis PET (positron emission tomography) scan tej zaum yuav muaj txiaj ntsig zoo rau kev npaj kho mob rau tus kheej. Cov kev kho mob uas muaj yog kev phais thiab radiotherapy raws li theem ntawm tus kab mob.

Kev Xeem:

Cytology (Pap smear), kuaj HPV, kuaj pom qhov muag nrog acetic acid (VIA), kuaj pom pom nrog Lugol's iodine (VILI). Qhov zoo tshaj plaws, kev tshuaj xyuas yuav tsum pib txij li hnub nyoog 25 xyoo.

Cytology raug pom zoo txhua 3 xyoos. Cytology + Kev kuaj HPV thawj zaug (kev sim sib koom ua ke) raug pom zoo ib zaug hauv txhua 5 xyoos.

Cov poj niam cev xeeb tub yuav tsum tau kuaj xyuas qhov tseeb thaum mus ntsib thawj zaug thiab yog tias ib txwm ncua kev tshuaj ntsuam mus txog tom qab yug menyuam (6 lub lis piam). Yog tias kev kuaj mob speculum qhia txog qhov txawv txav tsis tu ncua kev soj ntsuam raws tu qauv yuav tsum ua raws.

Hauv cov chaw muaj kev txwv tsawg, rau cov hnub nyoog 30-65 xyoo kev tshuaj ntsuam xyuas nrog VIA txhua tsib xyoos, raug qhia. Kev kuaj mob qog noj ntshav yuav tsum txuas ntxiv mus txog hnub nyoog 65 xyoo thiab tuaj yeem txiav tawm yog tias peb qhov kev ntsuam xyuas zaum kawg pom tseeb.

Kev tiv thaiv

Kev mob khees xaws ncauj tsev menyuam tuaj yeem tiv thaiv tau los ntawm cov tshuaj tiv thaiv tsis zoo li lwm yam kabmob kheesxaws. Ob qhov tshuaj tiv thaiv HPV muaj ntawv tso cai thoob ntiaj teb muaj nyob hauv Is Nrias teb; Lub hnub nyoog pom zoo rau kev pib txhaj tshuaj tiv thaiv yog 9 txog 12 xyoo, txuas mus rau 26 xyoo. Tag nrho peb koob tshuaj raug pom zoo. Cov tshuaj tiv thaiv yog txhaj ua ntej tus kab mob HPV; cov tshuaj tiv thaiv yuav tsum tau muab ua ntej kev sib deev debut. Nws yog yooj yim muaj, zoo heev thiab muaj kev phiv tsawg heev.