Cervical cancer, though the most common gynecological cancer amongst women in India, is one of the most easily preventable cancers. According to WHO, over 45000 women died of cervical cancer in 2019 in India. There is a need to generate mass awareness about the vaccination to prevent cervical cancer and the need for regular screening, said experts from Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC) Delhi. The month of January is celebrated as the Cervical Cancer Awareness Month.
“Early detection of cervical cancer is immensely possible as it has a long pre-cancerous stage of about 10 – 15 years and it can be easily tested by a simple test like PAP Smear which can even detect pre-cancerous stages thus preventing the development of cancer. Pap test is generally recommended every 3 years and if combined with HPV test in females more than 30 years of age, the testing interval can be increased to 5 years”, said Dr Vandana Jain, Consultant Gynae Oncology, RGCIRC.
High risk human papilloma virus (HPV) is the causative agent of most of the cases of cervical cancer. Generally, when exposed to HPV, a woman’s immune system prevents the virus from doing any harm. However In some women, the virus is not cleared spontaneously by the immune system and prolonged persistent infection with high risk HPV types results in cervical cancer.
“Unfortunately, in the early-stages, cervical cancer may be asymptomatic and symptoms may only appear when the cancer has reached an advanced stage. This underscores the need for regular screening to catch the cancer at an early stage. Abnormal menstrual flow, bleeding in-between menstruation, postcoital bleeding, post-menopausal bleeding, dirty vaginal discharge are the general symptoms of cervical cancer”, said Dr Vandana.
The risk factors for cervical cancer include having multiple sexual partners and onset of sexual activity at an early age. Sexually transmitted infections (STIs) and HIV increase the risk of HPV infection. Smoking is also associated with increased risk. Owing to poor hygiene, lack of awareness and inadequate screening the incidence of cervical cancer is higher in rural India than it is in urban India.
To reduce the risks of cervical cancer, one should get vaccinated against HPV. Vaccination is available for girls and women ages 9 to 26. The vaccine is most effective if given to girls before they become sexually active. Between 9-14 years of age, vaccines can be given in the form of two injections and between 14 to 26 years of age, three injections need to be given. However getting vaccinated is not a substitute for screening examinations, added Dr. Vandana.
The vaccine offers about 70-80% protection against cervical cancers. Therefore screening remains very important for early detection and management of the cancer. However, fewer than 1 in 10 women were screened for cervical cancer in the country in 2019.