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Professor Rezeberga from the Riga East University Hospital: a crucial aspect of high-quality cervical cancer treatment is the involvement of multiple specialists

January is Cervical Cancer Awareness Month, and the leading doctors from the Riga East University Hospital (hereinafter – the East Hospital) are raising public awareness this month, urging women to undergo State-paid screening tests and to consult about vaccination options against the human papillomavirus, the cause of this cancer. The multidisciplinary team of specialists at the East Hospital is a leader in Latvia in the diagnosis and treatment of precancerous conditions, collaborating with gynecologists, colposcopy specialists, oncologists, cytologists, pathologists, and laboratory physicians, which is a crucial aspect of high-quality cancer treatment.

The human papillomavirus (HPV) is one of the most commonly encountered sexually transmitted infections. Almost everyone is likely to become infected with it at some point in life, but, of course, cancer develops only in rare cases. It takes a long time, even more than 10 years, from the moment of infection with potentially cancer-causing viruses to the development of the disease. Initially, precancerous conditions develop, which we also look for during cervical cancer screening. Even if precancerous changes are detected, one must understand that a significant period of time will pass before the development of an oncological disease. This is the basis for performing screening analyses at specific intervals, explains Professor Dace Rezeberga, Lead Specialist in Gynaecology and Obstetrics of the Medical Board at East Hospital.

“The multidisciplinary team of specialists at the East Hospital is a leader in Latvia in the diagnosis and treatment of precancerous conditions, and a crucial aspect of high-quality treatment is the involvement of multiple specialists. The team consists of gynaecologists, colposcopy specialists, oncologists, cytologists, pathologists, and laboratory physicians, who work together to find an individualized approach to each patient’s treatment. They choose the safest treatment strategy, preventing the development of cancer and preserving women’s reproductive function,” points out Professor D. Rezeberga.

Cervical cancer screening tests are performed for women who have received an invitation for this examination as part of the cervical cancer screening programme implemented in Latvia. A woman can receive the invitation letter in her mailbox or in her registered personalized e-mail inbox on Latvija.lv. The invitation letter can be renewed by the family physician or gynaecologist using access to the screening database. The analysis is taken during a gynaecological examination, which is not painful and takes slightly more than ten seconds. Depending on the woman’s age, two screening tests are used in Latvia. From the age of 25 to 30, a cervical cytology examination is used, but from the age of 30 to 67, the presence of HPV is determined.

Latvia has developed modern guidelines for cervical cancer prevention based on the latest scientific evidence. In the diagnostic and treatment tactics, the life cycle of the human papillomavirus and its potential impact on cervical cells at different stages of a woman’s life are taken into account. Based on the patterns of cervical cancer development, different tests and testing intervals are used. In cases where abnormal test results are found, a precise strategy is applied to each situation, and it may involve additional testing from the material taken during the screening, repeating the test after a certain period, or referral for further examination under colposcopy control.

“In everyday work experience, we have come to the conclusion that unfortunately, women may not fully understand the significance of a positive HPV result, and they tend to become very anxious, sometimes incorrectly assuming that if they have this virus, it must involve some precancerous or malignant changes. However, that is not the case. HPV infection per se does not necessarily imply cervical disorders. It simply means that women who have a cancer-causing HPV have a higher risk of developing cervical cancer,” explains Associate Professor Jana Žodžika, Head of the Gynaecology Clinic at East Hospital.

When detecting high-risk precancerous changes, in order to prevent cancer development, a minor surgery is performed in the Day Surgery Unit of the Gynaecology Clinic, which involves the excision of the altered part of the cervical mucosa, known as cervical electrosurgical excision. It is a quick and straightforward procedure, comparable to repairing a tooth at the dentist, and in 90% of cases, it is effective. Similarly, if cancer is detected in a very early stage when its spread is only a few millimetres, it can also be prevented with a relatively small-scale surgery – cervical electrosurgical excision. After these procedures, a woman can still plan and have a successful pregnancy. Therefore, when it comes to cervical cancer prevention, it is crucial to be responsible and undergo the screening in a timely manner, which allows preventing cancer and avoid very serious consequences.

“We pursue the same goal as the World Health Organization, which consists in eradicating cervical cancer. This can only be achieved through public responsiveness and participation. We know that cervical cancer is relatively common among young women – for almost half of them, cancer develops around the age of 45, a time when a woman is still active in her profession, has developed her career, and has a family and children. Effective State-funded tools for combating cervical cancer are currently available in Latvia. Given that cervical cancer is caused by an infection, it can be primarily prevented through vaccination. Vaccination against HPV is included in the vaccination schedule in Latvia for 12-18-year-old girls and boys. Another tool is cervical cancer screening. I encourage everyone to use both preventive measures and, upon receiving an invitation letter, schedule a visit to the doctor,” urges Kristīne Pčolkina, a gynaecologist at the Gynaecology Clinic and a Board Member of the Latvian Colposcopy Association.


About the East Hospital

The Riga East University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities – “Gaiļezers”, “Latvian Oncology Centre” , “Biķernieki”, “Tuberculosis and Lung Disease Centre”, and “Latvian Infectious Diseases Centre”, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all oncology patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000 staff members.