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9 risk factors and early signs of cervical cancer, diagnose and protect with yourself.

Cervical cancer is the third most common cancer in women with up to 6,000 patients diagnosed with this disease per year. However, we can reduce the risk and incidence of cervical cancer if we take precautions early on. Therefore, every woman should be aware of this in order to take care of herself and her loved ones.


Getting to know cervical cancer

Cervical cancer is cancer that occurs around the cervix (the junction between the lower part of the uterus and the vagina) caused by the body being exposed to the Human Papillomavirus (HPV) making cervical cells becoming abnormal and eventually turning into cancerous cells. There are several strains of HPV which use numbers as names. Generally, HPV can be divided into two types according to severity, as follows:

·         HPV Low Risk Type is the type that causes genital warts including HPV 6 and 11.

·         HPV High Risk Type is the type that can occur in the vulva, penis, anus, mouth or throat, including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68.

However, there are only two strains are the most common: HPV 16, which occurs in up to 50% of cervical cancer cases, and HPV 18, which occurs in up to 15% of cervical cancer cases.


Risk factors for cervical cancer

Since cervical cancer is a disease caused by HPV, which can be transmitted through sex, women who have sex have a risk of cervical cancer. There are also other risk factors, including:

·         Age. As you get older, your risk increases, especially in women over 40.

·         Having sex at an early age and frequent change of sexual partners increase the chances of getting HPV.

·         Having had ulcers or inflammation around the cervix which was not treated.

·         Taking birth control pills for more than 5 years.

·         Failure to keep the vaginal area clean, including male genitalia.

·         Having children at an early age (younger than 20 years of age) including women with multiple children.

·         Smoking or drinking.

·         Having a history of other sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, or a disease that weakens the immune system such as AIDS.

·         Women who do not have regular gynecological examinations, so no lesions were found in the pre-cancerous stage.

However, in the case of HPV infection in 90% of women who have had sex, their bodies will be able to heal themselves within 1-2 years without showing any symptoms.


Warning signs of cervical cancer

-           Vaginal bleeding during non-menstrual periods or menopause, irregular menstruation (longer period, more quantity than usual, or after sex).

-           Abnormal vaginal discharge such as increased vaginal discharge with foul smell or blood.

-           Feeling pain during sex even if the vagina is not dry to the point of friction and having blood mixed with secretions that come out of the vagina in large quantities.

-           Pain in the lower abdomen or pelvis even if it is not near menstruation or having more severe abdominal pain near menstruation.

Patients may also experience: loss of appetite to the point that their weight drops; physical exhaustion all the time which makes them feel tired more than usual; and frequent urination or sometimes wanting to urinate but being unable to do so. These symptoms are similar to those of other diseases. Therefore, if you are concerned, you should see a doctor for further diagnosis.


Cervical cancer is preventable

Preventing cervical cancer starts with adjusting one’s behavior. We should reduce our behaviors that increase the risk of cervical cancer mentioned above. Other things that can help protect us from cervical cancer include vaccination and regular screening for disease. Here are more details:

- Vaccination to build immunity against HPV. There are several types of cervical cancer vaccines which are differentiated by the number of strains they protect. There are vaccines for two strains (HPV 16 and 18), four strains (HPV 6, 11, 16 and 18), and nine strains (HPV 6,11, 16, 18, 31, 33, 45, 52 and 58). All these vaccines protect against HPV 16 and 18 which are the high-risk strains that cause up to 70% of cervical cancer. For maximum efficiency, doctors recommend vaccination before having sex for the first time. Vaccination can be administered as young as nine years old. Women up to 45 years old who have had sex but have not been infected with HPV can be vaccinated but the earlier the vaccination the more effective it is.

- Pap Smear or Pap Test involves taking a sample of cells from the cervix to examine for abnormal cells that may develop into cancer. The accuracy is around 50%. Testing is recommended from age 21, or three years after the first intercourse. Testing should be done every 1-2 years. At age 30, if previous test results show no infection or lesions, the testing can be changed to every 3 years, except for high-risk groups, such as those with immunocompromised diseases. At the age of 70, if the results of the past 10 years show no infection or legions, the testing can be discontinued,

- HPV testing is a direct test for the DNA of HPV. It is usually done in conjunction with ThinPrep testing. The accuracy is around 90 – 95%. The doctor will take a sample of cells with a specific device to send for examination in one go. If the test shows no infection, there is a very small chance of developing cervical cancer and that person can wait up to 3 years before being tested again.

The accuracy of test results depends on the time of examination. The most suitable time is 10 to 20 days after menstruation, as the lining of the uterus has just come off, leaving the uterus clean so the tests show small deviations.

So, we can see that cervical cancer is a preventable disease. Just reduce risky behaviors and protect yourself from it by vaccination and having regular vaginal health checks.



·         Bumrungrad Hospital

·         Faculty of Medicine, Ramathibodi Hospital, Mahidol University

·         King Chulalongkorn Memorial Hospital, the Thai Red Cross Society

·         MedPark Hospital

·         Paolo Hospital

·         Phyathai Hospital

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