Gynaecologist Dr Erlang: Early-stage cervical cancer has zero specific symptoms

“Women arrive at the clinic with symptoms such as bleeding and pain, who are then subsequently diagnosed with cervical cancer; their treatment is often extremely long and complicated,” says Dr Külli Erlang, gynaecologist at the Women's Clinic of East Tallinn Central Hospital. “This disease isn’t really curable if women come to the clinic at a late stage.

However, cervical cancer and pre-cancerous conditions detected at an early stage can be successfully treated and then women will recover from this disease much more quickly and comfortably.

The Health Insurance Fund has a free of charge cervical cancer screening programme, through which insured and non-insured people receive answers about this disease. As it’s free of charge, everyone should take part in this programme.”

Estonia has one of the highest cervical cancer morbidity and mortality rates in Europe

According to statistics from the Health Insurance Fund,  an average of 150 women receive their primary cervical cancer diagnosis every year, with approximately 60 women dying due to the disease. These are the highest parameters in Europe.

“That is why it’s even more important for every Estonian woman and mother to take care of their health and get tested for this complex disease,” encourages Dr Erlang. “Ask your loved ones, friends and co-workers whether they have been screened and provide them with encouragement if they haven’t!”

You can register for cervical cancer screening at the Women's Clinic of East Tallinn Central Hospital (18 Ravi Street) and at the Tõnismäe Women's Counselling Offices (6 Hariduse Street). Book an appointment for yourself at the reception by calling 666 1900 or via the digital registry at ipatsient.ee.

In 2023, women born in 1958, 1963, 1968, 1973, 1978, 1983, 1988 and 1993 are eligible for free of charge cervical cancer screening.

Cervical cancer testing is quick and painless

The gynaecologist explains that the cervical cancer screening procedure is quick and painless. “During the screening process, an analysis is taken from the cervix by using a small brush in order to determine the existence of HPV,” says Dr Erlang. “Women who have HPV will remain under observation; if primary changes are found on the cervix during a follow-up, these are treatable.”

Free cervical cancer screenings have been conducted since 2006 in Estonia in order to help women detect cervical cancer at an early stage. Beginning at the age of 30, women are invited for a screening every five years.  You don’t have to wait for a personal invitation; you can register yourself by calling the reception at the Woman’s Clinic or also at a gynaecologist’s appointment.

The cervix of women under the age of 30 is monitored as well: in the case of young women, cells are taken from the cervix of women aged 25 and 28 (by gynecocytological test, PAP test or LBC test).

You can get vaccinated against the HPV virus that causes cancer

Additionally, getting vaccinated can prevent cervical cancer.

“The HPV vaccine against cervical cancer has been used for more than 10 years and is extremely effective, preventing over 85% of cervical cancer cases,” says Dr Erlang. “The HPV vaccine is safe and has minimal side effects. Girls between the ages of 13 and 14 get vaccinated free of charge at school because it’s most effective to get vaccinated prior to being sexually active. However, it’s also possible to get vaccinated later in order to protect yourself against cancer.”

What is the cause of cervical cancer?

Dr Külli Erlang, Gynaecologist at the Women’s Clinic of East Tallinn Central Hospital answers:

Cervical cancer is caused by HPV, also known as the human papillomavirus. It has more than 200 subtypes, 14 of which are high-risk types. If the virus remains in a woman’s body, it’s more likely to cause cell changes in the cervix, also known as cervical dysplasia. These are particular indicators than can be used to say whether cervical cancer will develop from that point.

Approximately two-thirds of adults are exposed to HPV during the course of their life. The virus spreads via skin-to-skin contact. Most people recover from the HPV virus, but approximately 10% of people will develop a persistent infection, which in turn makes them more susceptible to the subsequent potential scenarios. Sadly, suffering from HPV doesn’t create immunity, and a person can be infected repeatedly. Frequent exposure and the development of persistent HPV infection can in turn be a greater risk factor for cervical cancer.

Visit https://www.itk.ee/en/cervical-cancer-screening for more information and to register for screening.