Globally, more than a quarter of a million women die due to cancer every year. In India, cervical cancer is the second most common cancer among women. Approximately 1 lakh 20 thousand women are diagnosed with cervical cancer every year.
Cervical cancer affects the uterine cervix(the mouth of the uterus) and is caused by a sexually transmitted virus called human papillomavirus (HPV). Once a woman becomes sexually active persistent infection can lead to precancerous changes which in turn can turn fatal if left undetected and untreated.
? Early initiation of sexual activity
? Prolonged use of birth control pills
? Low socio-economic status with poor access to health care services
? Smoking
? Pregnancy before 17 years of age
? Full term 3 or more pregnancies
? Immuno-compromised status
The social stigma around womenĄŻs sexual and reproductive health issues acts as a barrier to timely intervention. A common symptom of cervical cancer can be?irregular or abnormal bleeding which can happen?during menstruation?or?after sexual intercourse. At times the patient may not have any symptoms. Women are mostly uncomfortable discussing this and misinterpret it as spotting or normal menstrual variation which causes further complications.
? Bleeding after sex
? Bleeding between menstrual cycles
? Bleeding after the cessation of menstruation
? Bloodstained vaginal discharge
Cervical cancer has distressing repercussions. When symptoms appear and women seek medical intervention, itĄŻs often too late. Cancer in such cases advances and becomes incurable. The two preventive measures are primary prevention by vaccination and secondary prevention via early detection and treatment of pre-cancerous lesions. Cervical cancer can be prevented through various screening tests like PAP smear, VIA and HPV testing.?
Procedures done to treat pre-cancerous lesions are also simple like cryo-cauterization, cold coagulation and loop excision. The HPV vaccine has been introduced as a precautionary measure and is administered between nine to twenty-six years of age. Ladies between the age of 26 to 45 years should consult their doctors for vaccination and may benefit.
Women, twenty-five years and above until age 65 years, should get themselves screened regularly once in every three years with PAP smear or with HPV testing and Pap smear once in 5 years or HPV test alone once in every 5 years. Further, new diagnostic methods using self-sampling for HPV may help us overcome logistic and cultural barriers.
Comprehensive disease control via proactive screening and HPV vaccination is the best way to prevent cervical cancer and reduce the overall disease burden. The universal HPV vaccination will eventually reduce the reliance on screening and also the incidence of HPV-related diseases. This in turn shall result in the simplicity of disease control and cost containment.
Lifestyle modifications can also help in preventing cervical cancer - women are advised to follow a healthy diet, avoid tobacco consumption and exercise regularly to minimise risk. Cervical cancer education should start as soon as girls attain puberty. Parents, friends, family and education institutes can also play a vital role in spreading awareness and early education.
Dr. Sabhyata Gupta is the Chairperson, Gynaecology and Gynae Oncology, Medanta Hospital Gurgaon. All views/ opinions expressed by the author are personal.
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