Cervical Cancer — Alarming Statistics
Cervical cancer is the 4th most common cancer in women worldwide and a leading cause of cancer death among women in developing countries. In Vietnam, the situation is concerning:
- Over 4,100 new cases per year — an average of 11 women diagnosed every day
- Over 2,400 deaths — an average of 7 women dying every day
- 70% are detected at late stages (stage III-IV) — due to lack of regular screening
- Average age at diagnosis: 45-55 years, but trending younger
The most encouraging fact: cervical cancer is one of the few cancers that is completely preventable if women get regular screening. Detection at the precancerous stage (CIN) results in a 100% cure rate using simple methods, without the need for chemotherapy or radiation.
With over 30 years of experience in obstetrics and gynecology, BSCKI. Trần Thị Thúy Lâm — formerly at the National Cancer Hospital (Viện K Trung ương), Hanoi Medical University Hospital, and Medlatec Hospital — shares a detailed guide on cervical cancer screening.
HPV — The Main Cause of Cervical Cancer
99.7% of cervical cancers are linked to HPV (Human Papillomavirus) infection:
What is HPV?
- Over 200 HPV types exist, divided into 2 groups:
- High-risk HPV: Types 16, 18, 31, 33, 45, 52, 58… cause cancer
- Low-risk HPV: Types 6, 11… cause genital warts (condyloma), benign
- Types 16 and 18 cause 70% of all cervical cancers worldwide
- HPV is primarily transmitted through sexual contact (including skin-to-skin contact, not just intercourse)
- 80% of women will be infected with HPV at least once in their lifetime — this is the most common sexually transmitted infection
The progression from HPV infection to cancer
HPV infection → (1-2 years) → Most clear naturally through immunity (90%) → 10% persist → (5-10 years) → Precancer (CIN 1 → CIN 2 → CIN 3) → (5-10 years) → Invasive cancer
Time from HPV infection to cancer: 10-20 years — meaning we have plenty of time to detect and treat at the precancerous stage with regular screening.
Who Needs Cervical Cancer Screening?
Should be screened (recommended for ALL women)
- Women from age 21 who are sexually active
- Women 30-65 years old — highest risk group, need regular screening
- Women who have not received the HPV vaccine
- Women who have been vaccinated against HPV — still need screening since the vaccine does not cover all high-risk HPV types
High-risk factors (need more frequent screening)
- Multiple sexual partners or partners with multiple partners
- Early sexual activity (before age 18) — the immature cervix is more vulnerable
- Smoking — doubles the risk compared to non-smokers
- Immunosuppression — HIV/AIDS, long-term immunosuppressive medications, organ transplant
- History of HPV infection or previous abnormal cells (ASC-US, LSIL, HSIL)
- Long-term oral contraceptive use (over 5 continuous years)
- Multiple vaginal deliveries (more than 3)
- No previous screening — never had a Pap smear
Recommended Screening Schedule — Per WHO and Ministry of Health
| Age Group | Method | Frequency | Notes |
|---|---|---|---|
| 21-29 years | Pap smear (cytology) | Every 3 years | HPV test not needed (HPV positivity is high but most clear naturally) |
| 30-65 years | Pap smear + HPV test (co-testing) | Every 5 years | Most optimal method |
| 30-65 years | Or Pap smear only | Every 3 years | If HPV testing is not available |
| 30-65 years | Or HPV test only | Every 5 years | Newer trend, increasingly common |
| Over 65 years | May stop | — | If adequately screened previously (3 consecutive normal Paps or 2 normal co-tests) |
Special note: Women with high-risk factors need more frequent screening — ask your doctor about the appropriate schedule.
Detailed Screening Methods
1. Pap Smear (Cervical Cytology)
The Pap smear is the classic and most widely used screening method:
Procedure:
- The doctor inserts a speculum to visualize the cervix
- Uses a small brush (cytobrush) or spatula to gently scrape the cervical surface
- Collects cells, which are either spread on a slide or placed in a preservation solution (liquid-based cytology — more accurate)
- Sent to a laboratory for pathologist examination under a microscope
Practical information:
- Duration: 1-2 minutes, quick
- Not painful — only slight discomfort, similar to a routine gynecological exam
- Results: 3-7 days (depending on the facility)
- Sensitivity: 60-80% (should be combined with HPV test for increased accuracy)
2. HPV Test (HPV DNA Test)
The HPV test detects high-risk HPV virus directly in cervical cells:
- Sample collection: Similar to Pap smear (or collected simultaneously)
- Detects: HPV types 16, 18, 31, 33, 45, 52, 58, and other high-risk types
- Advantage: Sensitivity over 95% — higher than Pap smear alone
- Especially important for women aged 30 and older
Combined Pap + HPV (co-testing) provides near 100% accuracy — this is currently the most optimal screening method.
3. Colposcopy
Colposcopy is a diagnostic method (not a routine screening tool):
- Uses a colposcope magnifying 6-40x to examine the cervical surface
- Applies 3-5% acetic acid to the cervix → abnormal areas turn white (acetowhite)
- Applies Lugol’s solution (iodine) → abnormal areas do not stain
- Biopsy (tissue sampling) at suspicious areas → sent for pathological confirmation
Colposcopy indications:
- Abnormal Pap smear (ASC-US + HPV positive, LSIL, HSIL, AGC)
- HPV type 16 or 18 positive (even with normal Pap)
- Post-coital bleeding with normal Pap
- Suspicious lesions on visual examination
4. VIA (Visual Inspection with Acetic Acid)
- A simple, low-cost method
- Applies 3-5% acetic acid to the cervix, observed with the naked eye
- Suitable for remote areas without testing facilities
- Lower accuracy than Pap smear and HPV test
Understanding Screening Results
| Pap Result | Meaning | Next Steps | Level of Concern |
|---|---|---|---|
| NILM (Normal) | No abnormal cells | Rescreen per schedule | Reassured |
| ASC-US | Atypical cells of undetermined significance | HPV test. If HPV negative → monitor. HPV positive → colposcopy | Don’t worry too much |
| LSIL (CIN 1) | Mild changes, usually from HPV | Colposcopy. Most resolve on their own within 1-2 years | Monitor, usually self-resolving |
| ASC-H | Cannot rule out high-grade lesion | Colposcopy + biopsy | Needs further evaluation |
| HSIL (CIN 2-3) | High-grade changes — precancer | Needs treatment: excision (LEEP/conization) | Needs prompt treatment — completely curable |
| SCC/Adeno | Cancer cells | Referral — National Cancer Hospital or specialized center | Needs immediate specialized treatment |
Important: ASC-US or LSIL results are very common and most resolve on their own — no need to panic. Only HSIL or above requires intervention. All abnormal results should be evaluated and managed by a specialist.
Treating Precancerous Lesions
If biopsy confirms CIN 2-3 (precancer), treatment options include:
- LEEP/LLETZ (electrosurgical excision): Uses electrical current to remove the affected area. Outpatient procedure, local anesthesia, 10-15 minutes. Most common method
- Cryotherapy: Freezes the affected area. Simple, no anesthesia needed
- Cold knife conization: Cone-shaped tissue removal using a scalpel. For complex cases
- Laser: CO2 laser ablation. Less common
Cure rate: 95-98% if detected at the precancerous stage. Follow-up Pap smears every 6-12 months for 2-3 years are needed after treatment.
Cervical Cancer Prevention — 5 Effective Measures
1. HPV vaccination
- HPV vaccine is most effective when given before age 26 (before first sexual contact)
- Can be given up to age 45 (still beneficial)
- 3 vaccine types: Gardasil 4 (4 types), Gardasil 9 (9 types — best), Cervarix (2 types)
- Gardasil 9 prevents 90% of cervical cancers
- Schedule: 2 doses (ages 9-14) or 3 doses (age 15+)
2. Regular screening
- Pap + HPV per recommended schedule — most important
- Even if vaccinated — still need screening
3. Safe sex
- Using condoms reduces HPV infection risk by 70%
- Limit the number of sexual partners
4. Don’t smoke
- Smoking doubles the risk of cervical cancer
- Tobacco chemicals accumulate in cervical mucus, weakening local immunity
5. Boost immunity
- Adequate nutrition (plenty of fruits, vegetables, vitamin C, vitamin E)
- Regular exercise
- Sufficient sleep (7-8 hours per night)
- Stress management
When to See a Doctor Immediately
In addition to regular screening, women should seek gynecological care immediately if they experience:
- Bleeding after intercourse — the earliest sign of cervical damage
- Bleeding between periods or bleeding after menopause
- Blood-tinged discharge or abnormally foul-smelling discharge
- Persistent pelvic pain of unknown cause
- Pain during intercourse (deep pain)
- Abnormal Pap smear results — seek medical consultation and management
Note: Early-stage cervical cancer usually has no symptoms. When symptoms become obvious (heavy bleeding, pelvic pain, weight loss), the disease is usually advanced. This is why regular screening is critically important.
Expert Advice
“Throughout my time working at the National Cancer Hospital and Hanoi Medical University Hospital, I have witnessed hundreds of cases of cervical cancer. The most heartbreaking fact is that most could have been prevented if the patients had been screened regularly. A Pap smear takes only 2 minutes and costs a few hundred thousand dong but can save a life. I always advise all women aged 21 and older: get screened for cervical cancer — don’t wait until you have symptoms.”
— BSCKI. Trần Thị Thúy Lâm, 30+ years of obstetric and gynecological experience
Cervical Cancer Screening at Phòng Khám Bác Sỹ Lâm — Lào Cai
Phòng Khám Sản Phụ Khoa Bác Sỹ Lâm is a leading trusted cancer screening facility in Lào Cai, offering comprehensive services:
- Colposcopy with specialized equipment — detecting microscopic lesions
- Pap smear + HPV test — the most accurate co-testing screening
- Cervical biopsy — when suspicious lesions are found
- BSCKI. Trần Thị Thúy Lâm — 30+ years of experience, formerly at the National Cancer Hospital (Viện K Trung ương), Hanoi Medical University Hospital, Medlatec Hospital
- Coordination with the National Cancer Hospital for referral when severe lesions or cancer are detected — ensuring patients receive treatment at a leading facility
- Coordination with Medlatec Hospital for HPV testing and cytology — accurate, fast results
Book a Screening
Call 0986 321 000 now to schedule a cervical cancer screening.
Address: 125 Hàm Nghi, Kim Tân, Lào Cai — Open 7 days a week, 7:00 AM - 7:00 PM
Early detection of cervical cancer = complete cure. Just 2 minutes of screening could save your life. Don’t delay — book your appointment today!
