Almost all cervical cancers (99.7%) are directly related to previous infection by one or more types of HPV (Human Papilloma Virus) that are oncogenic (Judson 1992; Walboomers et al, 1999). Infection occurs after active female sexual activity, usually begins after the age of adolescents (between the ages of 20-30 years) and progression to cervical cancer usually occurs after 10-20 years later, although in rare cases, some types of early lesions can be cancer in a short time within 1-2 years.
Which is a risk factor for cervical Cancer include:
- Sexual activity (age<20 years)
- Multiple sexual partners
- Exposure to IMS
- Mother or sister suffering from cervical cancer
- An abnormal PAP test earlier
- Decreased immunity, which caused suffering from HIV / AIDS or chronic use of corticosteroids (asthma and lupus).
- Pain during intercourse,
- Removing a little blood after intercourse,
- Excessive bleeding during menstruation (hypermenorrhea),
- Bleeding outside the menstrual cycle (Polymenorrhea),
- Abnormal vaginal discharge (color is not clear, odor or itching),
- At an advanced stage: no appetite, nausea, back pain, pain and swelling in the thigh, drastic weight loss, constipation, spontaneous bleeding after menopause, brittle bones easily and pelvic pain.
Prevention of cervical cancer can be divided into, as follows:
- Primary prevention, carried out by administering a vaccine is the most effective way to prevent cervical cancer and other genital cancers. Each person needs to be immunized at an early age before they are sexually active. Control Risks is very important (especially the modifiable risk factor) in preventing the chances of developing cervical cancer (cervical cancer).
- Secondary prevention, carried out by early detection of cervical precancerous lesions (as early as possible). Tests of cancer or pre-cancer is recommended for all women aged 30 to 50 years old through IVA test (Visual Inspection Acetic Acid). IVA test can be done at any time in the menstrual cycle, including during menstruation, during pregnancy and post-partum or post-abortion care. IVA test is very important for women who have a risk factor, especially in women suspected of exposure to STIs or HIV / AIDS.
IVA test can be performed in clinics that have the following facilities:
- Desk Check
- Sources of light / lamp
- Bivalved speculum (Cusco or Graves)
- Rack or container equipment.
The materials required to perform the test IVA must be available on site, including:
- Cotton swab sticks for
- Check out new gloves or surgical gloves that have been in DTT
- Spatula of wood and or condoms
- The liquid solution of 3-5% Acetic Acid (white vinegar can be used)
- 0.5% chlorine solution for decontamination of equipment and gloves
- Notes form to record findings.
Total Section (TB) Water = (% concentrate : % solution) - 1
- Effective for small and medium sized lesions (85-95% cure rate)
- Not expensive
- Can be performed by personnel other than physicians
- No need local anesthesia
- No need of electricity
- Few complications / side effects
- It can be done during pregnancy.
- Not suspected cancer
- Cervical cover no more than 75%
- Does not extend to the vaginal or cervical canal beyond cryoprob
- Extends no more than 2 mm of diameter prob of cryotherapy including prob end.
- Examining table
- Adequate light source
- Speculum Duck (Cusco or Graves)
- Tray or container equipment
- Cryotherapy Unit
- Supply of CO2 or NO2 regular.