Synonyms in the broader sense: cancer at the entrance to the uterus, uterine cesarean
English: cervical cancer / cervix cancer
Cervical cancer ( cervical carcinoma ) is a malignant degeneration of cervical cells and is one of the second most common cancers in women (affecting approximately 500, 000 women / year worldwide). As a prerequisite for the development of this cancer is primarily an existing infection with certain types of human papillomavirus (especially HPV type 16 and 18), which are usually transmitted by unprotected sexual intercourse. The persistent infection with the human papillomavirus initially causes cervical inflammation, which can lead to degeneration reactions in the cervix cells for a long time.
For example, 70% of cervical cancers have HPV type 16 or 18 infection. But other risk factors, such as smoking, long-term pill intake, genital infections of other causes (eg, chlamydia infection), a large number of births occurring, and immune system disorders, can also promote the development of cervical cancer. The main manifestation age of this disease is between the 45th and 55th year of life, whereby the infection with the human papillomavirus can already be years ago and the first precursors of the cancer between the 20th and 30 years can be noticed in the context of the gynecological check-ups.
The cervical cancer vaccine, as a special vaccine against the carcinogenic HPV types, is primarily intended to protect young women from infection with the HP viruses before the first sexual intercourse (that is, before a possibly already existing infection with the virus). However, it is important to note that there are other human papillomavirus types that, albeit much less often, can cause cervical cancer, but the existing vaccines are ineffective.
Since 2014, the Standing Vaccination Commission of the Robert Koch Institute recommends vaccination with the bi- or tetravalent vaccine against human papillomaviruses for all girls between the ages of 9 and 14 before the first sexual intercourse. If the vaccination has been missed during this period of time, however, this can be made up to the age of 18 at the latest. Even women from other age groups or women who have been sexually active at the time of vaccination can benefit from the vaccine if they have not yet had an infection.
Currently, two common cervical cancer vaccines are tested in use, differing in their spectrum of action. Both are produced by genetically modified insect or yeast cells and contain only non-infectious virus envelopes (dead vaccine) and not the virus itself.
A distinction is made between the bivalent (bivalent) vaccine (Cervarix®) administered since 2007, which is effective only against the two main risk HPV types 16 and 18 and has already been administered since 2006, tetravalent (tetravalent) vaccine (Gardasil®). It also prevents infection with HPV types 6 and 11 (these two viruses usually cause genital warts in men and women, but less so in carcinogenesis). The vaccine is usually administered by the doctor or gynecologist in the upper arm muscles, a second vaccination after about 6 months is then mandatory. At the age of> 13 or> 14 years or a vaccination interval between the two vaccinations of> 6 months, a third follow-up dose must be given.
Current studies indicate that currently available vaccines are nearly 100% effective against the particular HPV types covered by the vaccine. After the injection of the vaccine, the body's own immune system produces antibodies against the respective virus envelopes, so that a future infection leads to the successful detection and control of the viruses. Thus, the vaccinated women show no virus detection or malignant changes on the cervix within the next 5 years.
Recent studies have even shown that in some cases the vaccines protect against other types of HPV causing cancer (eg, HPV 45 and 31), although the vaccine does not directly target them. It is believed that this overall protective response is due to the similar growth of the virus, which causes the vaccine to make the immune system detect other viruses besides HPV 6, 11, 16 and 18. Whether the effect of the vaccine wears off after 5 years and therefore that a further boost of the vaccine after 5 years may be necessary can not yet be assessed with certainty. Large-scale studies investigate the question of the duration of protection.
Both bivalent and tetravalent cervical cancer vaccine are considered to be well tolerated, so severe side effects are a rarity. Among the more common, unwanted side effects include allergic reactions at the inoculation needle site (redness, swelling, itching) and fever. Patients with a known allergy to the ingredients in the vaccine should be advised against administration.
Other side effects may include nausea and vomiting, dizziness and fainting, and headache, muscle and joint pain. There are only five reports worldwide of cervical cancer in the development of inflammatory processes of the central nervous system. However, a direct link could not be established at the present time, just as in the only two deaths of girls who had been vaccinated.
Vaccination against cervical cancer.
After promising results in animal experiments, scientists have now been able to prove in the context of clinical trials that a newly developed vaccine is characterized by great efficacy and minimal side effects.
The vaccine consists of proteins similar to those of the human papillomavirus (HPV) envelope.
By vaccination, the immune system is stimulated to produce even protective proteins (so-called antibodies ) against the cancer-causing viruses, comparable to a workout.
The effect of the vaccine is enhanced by an additional activating agent acting on the immune system (a so-called adjuvant ).
An effective protection over 4.5 years could be proven for women from 25 to 55 years.
Studies show that the vaccine shows almost 100% efficacy against the precursors of cervical cancer if vaccinated before the first sexual contact.
Nevertheless, the vaccine in Germany is controversial.
This is due to the following issues. If a woman with an HPV virus becomes infected, that does not mean she's going to have cervical cancer.
The chance of developing cancer by infection with the HPV virus is less than 0.1%. Normally, the body's immune system fights the virus and the infection heals itself on average within 12-15 months.
Even if it is not successfully controlled by the immune system, first a so-called dysplasia, so a change in the cells, long before cancer arises.
These dysplasias can be divided into different stages. It usually takes up to 10 years to develop cancer from stage one.
In Germany, women are encouraged to visit a gynecologist once a year, who uses a swab to look for these cell changes.
So if a woman is infected with HPV and the cells change slowly, this is usually discovered long before the onset of cancer.
The rate of sexual abuse of women is over 50% in Germany, so only young patients will usually get a cervical cancer vaccine.
It is often assumed by vaccinated patients that you no longer have to go to cancer screening because they have been vaccinated.
But that is a common misconception. Cancer can also arise without HPV and is also triggered by other non-vaccinable HPV strains. Thus, it is advisable for every woman regularly to visit her doctor and get examined. Like any vaccine, the vaccine is only preventative, preventative and not if cervical cancer already exists.
This means that the HPV vaccine is no longer effective if the patient is already cervical cancer or has been infected with the HPV virus.
Despite the low probability of developing cancer, it may be advisable to get vaccinated. As mentioned above, there is a long way to go from infection to cell alteration to cancerous development, yet in more than 50% of all grade cell changes two and three HPV viruses have been detected.
In addition, HPV viruses can also cause other cancers, such as:
trigger. Therefore, many studies are currently being carried out to see if boys / men would not benefit from an HPV vaccine.
The HPV 6 and HPV 11 are responsible for over 90% of all genital warts, so vaccination could significantly reduce the number of people affected.
Because studies show here that by vaccination almost 100% of women can be protected from infection.
Overall, the cervical cancer vaccine should be vaccinated three times.
Vaccination is in the muscle, for example on the arm. The second vaccination takes place after two months, the third after three months. New study data show that the vaccination lasts at least 5 years, if it should be vaccinated again after that is not fixed yet.
In Germany, statutory health insurance companies are obliged to pay for vaccinations, which are recommended by the STIKO.
Therefore, the costs of about 170 euros are taken.
Private health insurance companies are not obligated, it depends on the respective health insurance, whether the costs for the HPV vaccination are taken over.
Since 2014, the health insurance funds have been obliged to fully assume the vaccination costs for girls between the ages of 9 and 14 years. The costs of missed vaccinations, which want / should be made up to the age of 18, are also covered by many health insurance companies. Deviating age groups should inquire in advance with the respective health insurance company about a possible reimbursement of costs, in some cases even costs up to the age of 26 are reimbursed.
The cost per administered vaccine amounts to approx. 160 Euro, which leads to a total price of approx. 320 Euro for a complete vaccination protection by two vaccine doses. The total annual costs for Germany amount to between 130 and 200 million euros.
Side effects: In itself, the vaccine is well tolerated and shows only minor side effects. There may be redness and light pain at the injection site. In addition, flu-like symptoms such as headache and body aches, as well as nausea and muscle pain can occur.
Fatigue and a gastrointestinal problem were also reported as undesirable side effects. There were no deaths in direct association with the HPV vaccine. A connection with thrombosis and the Guillan-Barre syndrome could not be proved. Cervical cancer can not be triggered by the vaccine.
The cervical cancer vaccine is a vaccine against viruses that can trigger genital warts and cervical cancer.
It is recommended by STIKO, the vaccination commission of Germany, for girls between the ages of 14 and 17 years. However, it can also be done earlier.
The vaccine is also called HPV vaccination. HPV stands for Human Papillomavirus. This virus can be transmitted sexually and therefore should be vaccinated before the first sexual contact.
There are hundreds of different HPV types, but HPV types 16 and 18 are responsible for over 70% of cancers.
Overall, there are two different cervical cancers.
Once a two combination fabric of type 16 and 18 vaccines and then a four-station wagon, which also contains the type 6 and 11.
The HPV types 6 and 11 are primarily involved in the genital warts.
Because cervical cancer vaccination (HPV vaccine) does not offer 100% protection, it can not replace precautionary smear tests (the vaccine currently only counters the two most dangerous high-risk types of the cervix responsible for about 70% of all cervical cancers).
There are plans for broad-based vaccination programs in the population, since the prevalence of human papillomavirus is high: Between 70% and 80% of all women in Germany, Austria and Switzerland become infected with HPV during their lifetime.
In general, the infection heals by itself within 12 to 18 months, so that, for example, a positive test for the virus is by no means linked to an existing or emerging cancer.
However, it is important to note that a vaccine has only preventive character: An infection with the virus can not be cured.
Therefore, it is planned to vaccinate especially the age group of the 12 to 14 - year olds (puberty) before the first sexual contact.
Not only girls but boys would benefit from the vaccine.
The HPV vaccine is also intended to protect against the benign genital warts of genital warts (which are harmless to cervix cancer and are therefore called low-risk types).
The future goal is to limit the cervical cancer and all precursors to a minimum that can no longer be reduced by the vaccinations.