Cervical cancer: first signs, screening and treatment in Tashkent

Other names: Цервикальный рак, карцинома шейки матки, плоскоклеточный рак шейки матки

Cervical cancer is one of the few cancers that is almost completely preventable. It develops slowly over years, passing through stages of dysplasia, and at each of these stages can be detected by simple and inexpensive testing. The tragedy of this disease is that the vast majority of advanced cases occur in women who have never had a Pap test.

🧾 МКБ-10: C53 🏥 Where it is treated: 2 Let's prevent with vaccination and screeningDevelops over the yearsEarly stages without symptoms

👨‍⚕️ Which doctor

Gynecologist, gynecological oncologist

🔬 Diagnostics

PAP test, HPV, colposcopy, biopsy, MRI

💊 Treatment

Surgery, radiation and chemotherapy

📈 Prognosis

Excellent in the early stages

⚠️ At risk

HPV, smoking, lack of screening

⏱ When to see a doctor

Immediately upon symptoms

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Кровянистые выделения после полового акта
Кровотечения между менструациями или в менопаузе
Обильные водянистые выделения с неприятным запахом
Боль внизу живота и в пояснице
Боль при половом акте
Отёк ноги, нарушение мочеиспускания — признаки распространённого процесса
Похудание и слабость

Why is this cancer preventable?

Unlike most malignant tumors, cervical cancer has a known specific cause - the long-term presence of oncogenic types of human papillomavirus. The path of development is also known: from infection through mild, moderate and severe dysplasia to invasive cancer.

This journey takes years, often more than ten years. All this time, the changes are at a stage where they can be detected by a simple study and cured with a small procedure. That is why in countries with established screening, the incidence has decreased significantly.

Two measures make this cancer almost entirely preventable: HPV vaccination and regular screening. Both are affordable and do not require complex technology.

Symptoms: why they are not present at an early stage

At the stage of dysplasia and early cancer there are no symptoms at all
Bloody discharge after sexual intercourse is one of the first noticeable signs
Bleeding between periods
Any bleeding after menopause
Copious watery or bloody discharge, sometimes with an unpleasant odor
Pain in the lower abdomen, lower back, sacral area
Pain during intercourse
In a common process: swelling of the leg, pain in the leg, difficulty urinating and defecating, blood in the urine
Weight loss, weakness, anemia

Обратите внимание: перечисленные симптомы появляются уже тогда, когда опухоль сформировалась. Дожидаться их — значит упустить период, когда disease предотвратима. Ранние стадии выявляет только скрининг.

Risk factors

Persistent infection with oncogenic HPV types is a major factor
Lack of regular screening is the main reason for advanced cases
Smoking significantly increases the risk
Immunodeficiency, HIV infection
Early onset of sexual activity, large number of partners
Multiple births
Long-term use of hormonal contraceptives - the contribution is small and is being discussed
Other sexually transmitted infections
Lack of HPV vaccination
Low socio-economic level as a factor in the inaccessibility of screening

Screening: what and when

Pap test or liquid cytology - evaluation of cervical cells
Testing for high-oncogenic risk HPV is the main screening method in many protocols
Combined cytology and HPV testing
The age of onset and intervals are determined by the doctor in accordance with accepted recommendations
If the results are changed - video colposcopy with targeted biopsy
Screening is also necessary for vaccinated women, since the vaccine does not protect against all types of the virus.
Screening is also needed in the absence of sexual activity at present, if it was previously

Separately, it is worth telling women who have had a hysterectomy: if the cervix is preserved, screening continues. If the uterus and cervix are removed for a benign reason, the issue is discussed with the doctor individually.

Diagnosis if suspected

Speculum examination and bimanual examination
Video colposcopy with targeted biopsy - confirmation of diagnosis
Curettage of the cervical canal with a lesion extending into the canal
Histological examination - determines the type of tumor
MRI of the pelvis - assessing tumor size and spread
CT scan of the chest, abdomen and pelvis
PET-CT in selected clinical situations
Cystoscopy and rectoscopy for suspected invasion into adjacent organs
Ultrasound of the kidneys to rule out compression of the ureters
General and biochemical blood test, assessment of kidney function

Treatment

Conization of the cervix - with preinvasive and microinvasive forms; may preserve the possibility of pregnancy
Trachelectomy - removal of the cervix while preserving the uterine body; organ-preserving option for young women in the early stages
Radical hysterectomy with parametrium removal and pelvic lymphadenectomy
Laparoscopic and open approaches depending on the stage and clinical situation
Radiation therapy, including brachytherapy
Chemoradiation therapy is the standard for locally advanced stages
Chemotherapy and targeted therapy for advanced disease
Ureteral stenting or nephrostomy for urinary tract compression
Discussion of fertility preservation before treatment in young patients

Тактика при этом заболевании определяется онкогинекологом совместно с лучевым терапевтом и химиотерапевтом. Крайне важно, чтобы решение принималось консилиумом, а не одним специалистом: от правильного выбора первой линии лечения напрямую зависит результат.

Where to get screened in Tashkent

Screening requires cytology, HPV analysis and, if changes occur, video colposcopy with biopsy.

In Tashkent, these studies are carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic; Once the diagnosis is confirmed, further treatment is determined jointly with the oncology service.

If you have never had a PAP test, this is the most important point of everything written above. One study every few years virtually eliminates the possibility of encountering an advanced form of this disease. Clinic contacts are below.

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

ПАП-тест (цитология шейки матки)from 325 000 Жидкостная цитология шейки маткиfrom 345 000 Мазок на ВПЧ (скрининг)from 305 000 Видеокольпоскопияfrom 140 000 Биопсия шейки матки с гистологиейfrom 1 250 000 Повторный приём онкологаfrom 200 000

💊 Treatment

Экстирпация матки надлобковым доступом (трансабдоминально)from 13 500 000 Лапароскопическая гистеросальпингоовариоэктомияfrom 14 450 000 Лапароскопическая радикальная экстирпация матки с придатками и селективной лимфаденэктомиейfrom 52 450 000 Радикальная экстирпация матки с расширенной лимфаденэктомией I категорииfrom 18 800 000 Радикальная экстирпация матки с придатками, лимфодиссекция II категории (прорастание в окружающие органы)from 23 600 000 Радикальная экстирпация матки с лимфодиссекцией I категории со стентированием мочеточниковfrom 29 800 000 Радикальная экстирпация матки, лимфодиссекция II категории со стентированием мочеточников (прорастание)from 36 200 000 Химиотерапия — стационар до 48 часовfrom 4 000 000

Frequently asked questions: Cervical cancer

Is it true that this cancer can be prevented?+

Yes, and this makes it special among cancer diseases. The reason is known - oncogenic types of HPV, the long-term development path through dysplasia is known, and there are simple methods for detecting changes in the precancerous stage. Vaccination plus regular screening makes this cancer almost entirely preventable.

What are the first signs?+

In the early stages there are no signs at all. The first noticeable symptom is usually spotting after intercourse, followed by bleeding between periods, heavy watery discharge, and pain. But by the time complaints appear, the tumor has already formed, so you need to focus on screening, and not on symptoms.

Is screening necessary after HPV vaccination?+

Yes, definitely. The vaccine protects against several of the most dangerous types of the virus, but not all. Therefore, vaccinated women continue to undergo regular screening on the same schedule. Vaccination and screening complement each other, not replace them.

Is it possible to preserve the opportunity to give birth?+

In the early stages - yes. There are organ-preserving options: conization for pre-invasive and micro-invasive forms and trachelectomy, in which the cervix is removed but the body of the uterus is preserved. The possibility of such treatment depends on the stage and type of tumor, so the issue of fertility preservation should be raised at the first discussion of treatment.

I was diagnosed with HPV. Does this mean I'll get cancer?+

No. Most sexually active people become infected with HPV at some point, and in the vast majority of cases, the body clears the virus within a year or two. Cancer develops only with long-term persistence of oncogenic types and not in everyone. What is really needed is regular monitoring so as not to miss changes.

Do I need to get checked after a hysterectomy?+

Depends on whether the cervix was removed and for what reason the operation was performed. If the cervix is preserved, screening continues. If the uterus and cervix are removed for a benign reason, the issue is resolved individually with a doctor. During surgery for oncological indications, observation is carried out according to a separate protocol.

At what age should screening begin?+

Age of onset and intervals are determined by current guidelines and take into account HPV status and previous results - this is worth discussing with your doctor. There is one universal principle: regularity is more important than frequency. It is years of complete absence of examinations, and not extended intervals, that are behind the majority of advanced cases.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated cervical cancer в Ташкенте

Ключ к победе над этим заболеванием — скрининг: ПАП-тест, анализ на ВПЧ и кольпоскопия. В Ташкенте эти исследования, а также биопсию шейки матки, проводят в медицинском центре UROLOGIC COMPLEX и в clinicsе Tashkent Medical Park; лечение при подтверждённом диагнозе определяется совместно с онкологической службой.