‘Proper awareness and treatment can prevent cervical cancer in women’
Guwahati, Feb 4: According to a Lancet report, India accounts for the highest number of cervical cancer cases in Asia, followed by China. According to the research, out of the 40% of the total deaths from cervical cancer, 23% occurred in India and 17% in China. While the disease is preventable, very few are aware of it, its implications and treatments.
“Fortunately cervical cancer is preventable because it is not genetic. Despite the fact that it can be prevented, it is the second leading cause of death of women in India, while the first one is breast cancer,” said Dr. Geeta Baruah Nath, senior obstetrician, gynaecologist, laparoscopic surgeon, and infertility specialist.
Dr Nath explains that cervical cancer is the abnormal growth of cells in a woman's cervix- — the lower part of the uterus that connects to the vagina. India accounts for the bulk of deaths from cervical cancer and among the different States of India, Arunachal Pradesh holds the highest number of incidence.
How is Human Papillomavirus HPV related to cervical cancer?
Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). Many people with HPV don't develop any symptoms but can still infect others through sexual contact. “The virus gets through sexual contact when a girl is exposed to sex and the man is infected with the virus will transfer it to the girl,” informed Dr Nath.
HPV has 100 strains out of them 16-18 are carcinogenic and they can cause cancer. Some are mild which causes warts, added Dr Nath.
How does it spread?
Dr Nath also said that if the virus persists for a long period almost 20% of it can multiply and become precancerous. Usually it resolves up to age 30 spontaneously, however, if it persists then it will be pre-cancerous stage.
Age at the time of marriage also matters, as if a girl is sexually exposed in a tender age she might also get infected with HPV.
What are the common causes?
Some of the common causes are early pregnancy, genital hygiene, long dose of contraceptive pills, smoking, nutritional status, immune deficiency or already infected with other diseases.
What are the symptoms?
“If one experience irregular bleeding, internal menstrual bleeding, bleeding after intercourse, pain during intercourse, post menopause bleeding, foul smelling watery discharge, foul smelling bloody mucus, it’s advisable to visit a physician at the earliest.” said Dr Nath.
At pre cancer stage one do not experience the symptoms, even at early stage one is not aware of the symptoms- for this regular check-ups, screening, are indispensable.
Prevention is the key to reduce early detection and timely treatment
Some of the measures that Dr Nath suggests are:
1. Regular gynaecological check up
2. All girls sexually active between age group 21-30 must go for Pap smear test which is easily available in hospitals and are affordable.
3. After age 30 upto 65 one must go for Pap smear along with HPV DNA – this detects if there is any presence of virus
4. Screening test for prevention for cervical cancer through Liquid Based Cytology (LBC) along with HPV DNA is more informative.
5. Suppose in rural areas where there is no awareness or Pap smear test is not available then VIA- Visual Inspection with Acidic Acid is the way which needs to be conducted by trained health workers to detect the presence of any cancer causing agent.
How often should one go for tests?
As per the December, 2022, WHO Position on HPV vaccines, WHO recommends the following schedule:
A one or two-dose schedule for girls aged 9-14
A one or two-dose schedule for girls and women aged 15-20
Two doses with a 6-month interval for women older than 21
A minimum of 2 doses and when feasible 3-doses remain necessary for those known to be immunocompromised and/or HIV-infected.
Vaccine
Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines, namely Gardasil and Cervarix. Meanwhile, the Government of India has said cervical cancer vaccine for girls aged between 9 and 14 years will be provided primarily through schools by mid 2023. The National Technical Advisory Group for Immunization (NTAGI) has recommended introduction of HPV Vaccine in the Universal Immunization Programme (UIP) with a one-time catch-up for 9-14 year-old adolescent girls followed with routine introduction at 9 years.
Dr Nath further said that awareness is the need of the hour, “Those who do not go to school need awareness about cervical cancer, screening and vaccine. Moreover, girls who do not attend school need to be reached out, made aware, check their eligibility and keep records. Married or 30 + women can also get the vaccine, but ideally it should be given before sexual intercourse for beneficial effect.
Notable, pregnant and women post-delivery up to 3 months are not advised to take the vaccine, Dr Nath added.
