Cervical cancer is the fourth most common cancer among women in the world, despite being entirely preventable. India accounts for nearly 16 per cent of the cases, and yet, very few women are screened in the country.
In a video interview, FIT speaks to a doctor about the risks, causes and prevention of cervical cancer - and why vaccination and timely detection can make a huge difference.
Read her answers here:
Who is at risk of cervical cancer?
Cervix is the lower part of the uterus. Every woman is at risk of cervical cancer, but the higher risk groups include women who are infected with Human papillomavirus (HPV) - which accounts for over 90% of all cervical cancer cases.
HPV is a sexually transmitted infection, so any sexually active woman can be infected with the virus. Having sex at an early age or having multiple partners can increase the risk of contracting it. Not using condoms, being immunocompromised, smoking, or - some studies have found - using oral contraceptive pills for over five years - can also increase your risk.
But not every woman who gets HPV develops cervical cancer. In fact, for most women, the immune system clears off the virus before it can lead to any complications.
Women in which age group are more vulnerable to cervical cancer?
Cervical cancer has got a bimodal age presentation, meaning women at two age groups are at increased risk. Even though the risk is present all throughout the period of sexual activity, the incidence of cancer peaks after the age of 30 and 60.
What are the signs and symptoms of cervical cancer?
Usually, it is a very silent kind of a disease. But some subtle symptoms could help suspect the cancer:- any form of abnormal bleeding (in between your cycle or post sex), having continuous vaginal discharge (increased amount and foul smell),or having lower back pain are a few vague signs.
Is cervical cancer preventable?
Yes, most definitely. It is one of the cancers which have a long latent period, which means that if somebody is infected with HPV, it takes about 10-15 years usually for the cancer to develop. The long course of history gives us an ample amount of time to pick up the abnormal cells from the cervix.
We have very good screening practices inplace for this cancer. The pap smear test along with HPV testing form the core foundation of how cervical cancer can be prevented. A woman should get a pap smear done from 21 years of age - or later when she gets sexually active. It is a small test where a smear is taken from the gynecologist does a pelvic exam and takes a smear of cells from the cervix. These cells are then analysed and any abnormalities are noted, according to which further HPV testing or screenings are recommended.
The pap test is not 100% protective. In fact, the sensitivity is quite low. But getting it done repeatedly and regularly, getting visualisation of the cervix done, along with HPV testing after 30 years of age, is known to increase sensitivity of the pap smear. So if one gets all things things, then the chances of picking up smaller precancerous lesions increase.
How often should a woman get screened?
The testing should begin from the age of 21 or after a woman is sexually active.
The pap smear should be done every year until the age of 30, after which cotesting with HPV can be initiated as well. If things are normal, a doctor may tell you to increase the duration and get tested every five years instead of three.
What is the HPV vaccine and when should you get it?
Vaccines exist for the HPV infection and are known to reduce cervical cancer risk by about 80-90%. It should be administered to a girl child from the age of 9 till when she is sexually active. It needs to be taken in two doses, is very safe and has good efficacy.
However, the vaccine is not a replacement to testing and screening, as it is cannot offer 100% protection. It is still extremely important to get the cervical smears and HPV screening as laid out above.
What are the chances of recurrence in cervical cancer?
That would depend on the biology and the stage of cancer one is in. A woman in stage one has got a 20% chance of recurrence, while another in stage 3 may have a 50-60% chance of recurrence. But a certain estimate can only be given looking at the individual case and how she has responded to treatment.
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