Primäre Prävention – Mamma- und Genitalkarzinome

In den letzten Jahren haben sich Diagnostik und Therapie im Bereich der gynäkologischen Onkologie und Senologie stetig weiterentwickelt. Dennoch ist das Versterben an einer Krebserkrankung in den hoch entwickelten Ländern eine der häufigsten Todesursachen der Frau [1]. Maßnahmen zur Primärprävention sind daher von hoher Bedeutung, um die Morbidität und Mortalität von Krebserkrankungen zu senken.

Kernaussagen

• Ein Teil der gynäkologischen Krebserkrankungen wird von vermeidbaren Risikofaktoren gefördert. Hierzu gehören Infektionskrankheiten, Umweltfaktoren, schlecht eingestellter Diabetes mellitus Typ 2 und ein ungesunder Lebensstil, insbesondere Nikotin- und Alkoholkonsum, Adipositas, ungesunde Ernährung und geringe körperliche Aktivität.

• Maßnahmen der Primärprävention können den Einfluss der modifizierbaren Risikofaktoren einschränken oder ganz unterbinden.

• Für das Mamma- und Ovarialkarzinom wirken z. B. Schwangerschaft und Stillen protektiv. Bei positiver Familienanamnese sowie bei hohem Erkrankungsrisiko kann eine genetische Testung das Erkrankungsrisiko abklären mit entsprechenden Vorsorgemaßnahmen je nach Befund.

• Beim Mammakarzinom wirkt bei hohem Risiko die Prävention mit Tamoxifen präventiv, beim Ovarialkarzinom eine Sterilisation mit Tubenligatur oder Salpingektomie.

• Für das Endometriumkarzinom wirken neben den allgemeinen Maßnahmen zum Lebensstil auch Intrauterinpessare und orale Kontrazeptiva risikoreduzierend.

• Die effektivste Maßnahme der Primärprävention für das Zervixkarzinom besteht in der Impfung gegen mehrere Varianten des humanen Papillomvirus (HPV), andernfalls der Gebrauch von Kondomen.

Schlüsselwörter

Primäre Prävention - Mammakarzinom - Zervixkarzinom - Ovarialkarzinom - Endometriumkarzinom

• Literatur

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