The negative statistics for cervical carcinoma are well known, very startling and, unfortunately, completely real. Every year, 270,000 women worldwide die from cervical cancer, one woman every 2 minutes. In Europe this happens every 18 minutes. In Bulgaria, one woman dies every day and 3 new cases of the disease are diagnosed. The scariest thing about these indicators is that cervical carcinoma is the only one that is completely preventable and curable if diagnosed in time. Very often, a woman begins to pay attention to the prevention and prevention of her gynecological health only when the first symptoms of a health problem are present. Regular prophylactic gynecological examinations are a major factor in early disease detection and increasing the chances of successful treatment. In practice, timely prevention saves life. This is the motto of the specialists from the gynecological preventive medicine sector at the “Dr. Shterev” Medical Complex. To encourage the ladies to take small steps towards a healthy and happy life, the specialized offices for oncology prevention and mammology in the complex offer preventive programs aimed at prevention of women’s health. Among them, specially developed preferential packages for annual prevention of gynecological diseases and for screening focused on the fight against cervical cancer deserve attention. NEWS_MORE_BOX The indicators in Bulgaria for this type of oncological disease show increasingly alarming results, which places us in one of the last places in Europe and in the middle of the world. Our country is characterized by a continuous increase in mortality and morbidity, as well as an unfavorable stage distribution. The stage distribution of patients, in turn, is the most accurate indicator of the effectiveness of screening programs and early diagnosis. The lowest-performing countries have well-developed and optimized screening and prevention programs. An example of such a country is Finland, where organized mass screening covers about 80-85% of the population. Unlike other European countries, which focus primarily on prophylaxis and prevention, providing quality healthcare to its residents, in Bulgaria the emphasis is on the treatment of cancer cases that have already occurred. The main measures that can be taken against cervical cancer are the various types of prevention. Primary prevention includes activities to affect the external and internal environment of the person, with a view to excluding or reducing carcinogens and predisposing factors. Secondary prevention combines methods for detecting malignant tumors at an early stage, or at a stage preceding the development of cancer. At the heart of this formulation is the concept of carcinogenesis, namely that cancer does not appear suddenly, but is the result of various preceding changes.Tertiary prophylaxis carries out active follow-up of already treated patients and it aims to provide anti-relapse and rehabilitation measures. Primary prevention in this case is based on HPV vaccination, which requires a nationally initiated and funded campaign. The introduction of primary prevention, of course, does not cancel the implementation of secondary prevention. It relies on different types of screening (mass and opportunistic). Mass screening is again a matter of state policy and strategy. In Bulgaria, programs for the prevention and screening of oncological diseases are currently completely absent or initiated sporadically. As a result, our country ranks in one of the first places in terms of morbidity and mortality from cervical cancer. Following the philosophy of Associate Professor Atanas Shterev, that medical facilities should be socially responsible and actively and independently participate in the so-called opportunistic screening, we at the “Dr. Shterev” Medical Complex are developing various campaigns to promote oncological-gynecological preventive examinations and preventive medicine activities. This activity rests on the understanding that due to the lack of mass screening in our country and any other involvement of the state with this problem, every responsible obstetrician-gynecologist and specialized medical facility must join the fight against cervical cancer. . Every gynecological examination must be oncologically oriented (opportunistic screening). We focus on the prevention and treatment of precancerous lesions detected through our screening program, which is applied in the specialized sector of preventive medicine. We provide optimal screening for all our patients in the hope of improving the frightening statistics, even if it is minimal against the background of the whole country. In order to optimize our screening program, we opened a histo-pathological laboratory on the territory of the complex for the study of histological and cytological materials. We replaced the standard oncocytosmear with a new generation of cytology (much more sensitive and of better diagnostic value) and equipped the sector with a specialized Thin Prep processor, which implements the latest method of performing cytosmears using liquid-based technology. We have replaced the standard colposcopy device with a video colposcope with HD resolution. In order to perform a high-quality and adequate oncoprophylactic gynecological examination, in addition to an oncocytosmear, it is recommended to perform a colposcopic examination. A method known for a long time, but, unfortunately, little used by obstetricians and gynecologists in our country. In this way, we could get a better idea of the condition of the cervix and provide adequate diagnosis and treatment to our patients, if necessary. The video colposcope, in turn, provides many possibilities:every review is recorded and stored; enables consultation of our patients with colleagues from the country and abroad; provides better monitoring of the condition of treated patients; an electronic file of the screened patients is created. In conclusion, we can say that adequate and high-quality prevention would completely replace the need for treatment. We believe that prevention saves life, while treatment, unfortunately, cannot always do so. Dr. Ivan Dimitrov is an obstetrician-gynecologist, a specialist specialized in oncogynecological prevention. Works at Dr. Shterev Medical Complex. Dr. Ivan Dimitrov graduated from Medical University – Pleven in 2008, after which he was enrolled for specialization in obstetrics and gynecology at PSAGBAL “St. Sofia”. In 2010, he became part of the team of AG Hospital “Shterev” with the main focus on oncological prophylaxis under the leadership of Prof. Atanas Shterev. In 2012, he acquired the specialty “Obstetrics and Gynecology”. He has additional qualifications in the field of diagnostic laparoscopy in gynecology (2011, London), basics of colposcopy under the guidance of Professor Albert Singer, consultant at University College and Whittington Hospitals, England (2012, Sofia), “A to Z Suturing Laparoscopy Course” under the supervision of Dr. Rudy Campo, Dr. Stephan Gorts and Professor A. Vatier (2012, Leuven, Belgium), Colposcopy and destructive treatment of cervical precancers” under the supervision of Professor Victor Zlatkov, SBALAG “Mother’s House” (2013, Sofia), transvaginal laparoscopy (2013) Dr. Dimitrov’s main interests are in the field of operative gynecology and more specifically the application of endoscopic techniques, oncogynecology and oncological prophylaxis in the field of gynecology. He is a member of the Bulgarian Medical Union, the Bulgarian Association for Sterility and Reproductive Health and the European Society of Human Reproduction and Embryology (ESHRE).basics of colposcopy under the guidance of Professor Albert Singer, consultant at University College and Whittington Hospitals, England (2012, Sofia), “A to Z Suturing Laparoscopy Course” under the guidance of Dr. Rudi Campo, Dr. Stefan Gorts and Professor A. Vatier (2012, Leuven, Belgium), Colposcopy and destructive treatment of cervical precancers” under the supervision of Professor Viktor Zlatkov, SBALAG “Mother’s House” (2013, Sofia), transvaginal laparoscopy (2013 ) Dr. Dimitrov’s main interests are in the field of operative gynecology and more specifically the application of endoscopic techniques, oncogynecology and oncological prevention in the field of gynecology. He is a member of the Bulgarian Medical Union, the Bulgarian Association for Sterility and Reproductive Health and the European Society of Human Reproduction and Embryology (ESHRE).basics of colposcopy under the guidance of Professor Albert Singer, consultant at University College and Whittington Hospitals, England (2012, Sofia), “A to Z Suturing Laparoscopy Course” under the guidance of Dr. Rudi Campo, Dr. Stefan Gorts and Professor A. Vatier (2012, Leuven, Belgium), Colposcopy and destructive treatment of cervical precancers” under the supervision of Professor Viktor Zlatkov, SBALAG “Mother’s House” (2013, Sofia), transvaginal laparoscopy (2013 ) Dr. Dimitrov’s main interests are in the field of operative gynecology and more specifically the application of endoscopic techniques, oncogynecology and oncological prevention in the field of gynecology. He is a member of the Bulgarian Medical Union, the Bulgarian Association for Sterility and Reproductive Health and the European Society of Human Reproduction and Embryology (ESHRE).
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