Cervical cancer is formed by malfunctioning cells. Most often, they arise from the flat “squamous” cells covering it. The process of transforming cells from “normal” to “cancerous” usually takes years. This period is described as precancerous. It is characterized by dysplastic and precancerous changes of the cervix. These changes can be “captured” when conducting a PAP test – Pap test. The high degree of result III, especially IV indicates a high risk. Starting the process of degeneration of normal cells into cancer is due to sexually transmitted infections. 99.8% of cases of cervical carcinoma are associated with infection with oncogenic human papillomavirus. There are hundreds of types of human papillomavirus viruses, and only some of them cause cancer, others lead to the formation of warts. In all cases, the clinical manifestations of HPV infection are unpleasant. 80% of women become infected with HPV during their sexually active lives. The highest risk for cervical cancer are types 16, 18, 45, 31 and 33. They cause more than 80% of cervical cancer cases worldwide, and in Bulgaria – 97%. NEWS_MORE_BOX Persistent infection with oncogenic HPV is considered a major risk factor for cervical cancer. There are two peaks of HPV infection, soon after the onset of sexual life between the ages of 18 and 22 and to a lesser extent between the ages of 30 and 40. Even at an early stage of the disease, symptoms are absent or unrecognizable to an affected woman. Such are reported in an advanced stage of the disease. Complaints include pain in the lower abdomen or during sex and non-specific non-menstrual bleeding. The earlier the changes of the cervix are detected, the better the prognosis and the probability of a successful cure. Precancerous conditions affect only the surface layers of the cervix, which gives high effectiveness to timely and adequate treatment. As the cancer progresses, it covers the tissues in depth, adjacently, and can metastasize. Early diagnosis of cervical cancer is carried out by the PAP test, named after its creator Papanikolaou. In the test, the pap smear, cells taken from the surface of the cervix are examined for changes. With the help of the PAP test, 95% of cases of precancerous changes can be detected. If the smear is high, a colposcopy is performed to examine the cervix for changes. Most often, precancers are treated by conization – it is a surgical removal of the changes, by cutting out a cone-like section of the cervix. Another popular method is through laser surgery. Cervical cancer can be prevented by building protection against oncogenic HPV infection and conducting regular screening for cervical cancerous changes.Pap smears should begin between the ages of 20-30 and continue until age 60. The vaccine creates immunity against two of the HPV types, 16 and 18, with the greatest epidemiological frequency. They are associated with 70% of cervical squamous cell and adenocarcinomas. The vaccine is administered in 3 doses. In our country, it is placed at the earliest at the age of 12. From this year, it is reimbursed by the NHIF. Vaccines are registered in all countries of the European Union. In 18 of them, they have included HPV vaccines in their Immunization Calendar. Cervical cancer is the second most common cancer among women, after breast cancer. Every year in Europe, 50,000 women get cervical cancer, and 25,000 die. In our country, every day one Bulgarian woman dies from cervical cancer. According to the National Cancer Registry, about 1,200 women get sick every year. In Bulgaria, in the last 20 years, there has been a clear trend of increasing cases of cervical cancer. Effective screening programs can prevent 80% of this disease. In Bulgaria, the 5-year survival rate from cervical cancer is 44%, in EU countries – 62.6%. Only 10% of Bulgarian women are defined as very well informed about cervical cancer, according to a study by Alpha Research. Another 37% place themselves in the “more familiar” group. Only 5.5% of Bulgarian women are categorical that the main cause of cervical cancer is the human papilloma virus. 22.8% claim that they are more familiar with this fact. to European Cervical Cancer Prevention Weekthat the main cause of cervical cancer is the human papillomavirus. 22.8% claim that they are more familiar with this fact. to the European Cervical Cancer Weekthat the main cause of cervical cancer is the human papillomavirus. 22.8% claim that they are more familiar with this fact. to the European Cervical Cancer Week