1. The summary of preventive examinations- cervical cancer Agnieszka Wrzesińska, MD Project entitled „ Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn” co-financed by Norwegian Financial Mechanism 2009-2014 and State budget within the Programme PL13 Reducing social inequalities in health

2. Cervical cancer

3. Cervical cancer - statistics Cervical cancer is the SECOND, after breast cancer, most common cancer in the world which affects women. 500 thousand of women are affected by this dangerous disease every year, 270 thousand of them die. 60 thousand are affected in Europe and 30 thousand die... Over 3600 NEW CASES each year in Poland, 1800 women DIE. According to statistical data, INCIDENCE RATE AND MORTALITY RATE from cervical cancer in POLAND gives her one of the TOP rates among the countries of the European Union.

4. Cervical cancer = statistics

5. Naked truth about cervical cancer Cervical cancer is a threat for every women, irrespective of her age, social status or lifestyle. This disease can ruin the chance for maternity. Unfortunately, it often leads to death in Poland. Still not enough women know that cervical cancer might be prevented in a simple way – through regular performance of cytological examination!

6. Cervical cancer – silent killer Cervical cancer can develop for years hardly ever giving any symptoms at the beginning. 60% of cervical cancer is identified very late in Poland – in a second or even third stage of advancement when the treatment could be less effective. Women visit their doctor only when they observe alarming symptoms which could be the evidence of an advanced stage of cancer. If it concerns you, please do not delay the visit at the gynaecologist's!

8. The possible symptoms of cervical cancer: abnormal vaginal bleeding (bleeding between regular periods, periodical bleeding which lasts longer and is more profuse than usual, bleeding after menopause), contact bleeding (after sexual intercourse, shower or gynaecological examination), profuse vaginal discharge, pain during sexual intercourse, pain in lower abdomen,

9. Risk factors of the cancer development chronic infection with human papillomavirus (HPV type 16, 18), age between 45 and 55, many sexual partners, early beginning of sexual life (c.16 years old), many childbirths, vaginal inflammations found earlier, changes indicated in pap smears, smoking cigarettes, longlasting hormonal contraception, diet low in antioxidants,

10. HPV (human papilloma virus)

11. There are over 100 types of the virus. HPV virus is usually sexually transmitted and also as a result of having contact with the skin of your partner's sexual organs. The majority of HPV infections gives no symptoms and remit spontaneously but some of them might cause cancer. Cancer is a result of oncogenic types. Types 16 and 18 are responsible for over 70% of infections which lead to te development of abnormal cells and as a consequence to the development of cancer.

12. The most effective method of cervical cancer prevention is the combination of vaccinations against HPV and the performance of regular pap smear.

13. Cytological examination (pap smear) A pap test is a first and most important diagnostic examination which allows to detect not only an advanced stage of cancer but also the preceeding stages which are often curable. It allows to define the condition of the cells of endocervix and extocervix taken by a one-off professional brush. It is the easiest and non-invasive way of detecting cancerous changes within the cervix.

14. Cytology saves your life! Cytology should be performed by every sexually active women and every women who begins her sexual life. It is advisable to have a pap smear done between 10 and 18 day of menstrual cycle, at least 2 days after the period or 5 days before. According to statistics 60% of women who suffer from cervical cancer have never pap smear done! Only 1/3 of women perform regular cytological examination in Poland!

15. Cytology saves your life! It is advised to perform the examination once a year (at least every 3 years). It allows to detect really minor precancerous changes in the cervix and as a consequence the treatment might be applied quickly and effectively. The crux of cytology is not only the detection of cancer but also the assurance that everything in our body is in order. All women between the age of 25-59 are subjected to free-of-charge cytological examination within National Health Fund once every three years.

16. What if…? If there are any abnormalities in cytological examination then the next stage is the biopsy from the cervix area where we suspect the appearance of cancerous change. The biopsy is taken by a colposcope – optical device allowing the observation of the cervix and the interior of the cervix in a great enlargement. Only the result of histopathological examination allows to diagnose with a preinvasive cancer or invasive and the beginning of an appropriate treatment.

17. You do not have to die from cervical cancer! Do the pap smear! Therefore…

18. „Equal in health” The following number of preventive examinations has been performed till today within the project „ Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn” : -Laboratory examination (morphology with smear) – 2351, -gynaecological consultation – 960, -transvaginal ultrasound examination – 480, - cytological examination – 2352, -colposcopic examination– 66.

19. In the end…

20. Thank you for your attention Project entitled „ Equal in health – prevention and early detection of cancers as well as health promotion in the Poviat of Kwidzyn” co-financed by Norwegian Financial Mechanism 2009-2014 and State budget within the Programme PL13 Reducing social inequalities in health