Cervical Cancer And Its Prevention: All You Need To Know

Cervical cancer is the second most common type of cancer in India and is mostly associated with a virus called human papillomavirus (HPV).  This cancer occurs when cells change in a woman’s cervix. It should be taken seriously as it can affect the deeper tissues of the cervix and can spread to the other parts of the body such as lungs , bladder , liver , rectum and vagina and get metastasized.

What is cervical cancer?

A cancer that begins with an unusual change in the cells of the cervix. This is a slow growing cancer and can be detected in the early stages with regular screenings and can be treated on time before it causes more serious problems. Cervical cancer can be mainly of two types:

• Majority of cervical cancers are Squamous cell carcinomas.
• The remaining cervical cancers are Adenocarcinomas.

However, very rarely a mixed type of cancer is seen which has the features of both types.

What are the symptoms of cervical cancer?

Cervical cancer does not show any symptoms till a woman is in the advanced stages or even if it does it is mistaken as menstrual periods or urinary tract infections (UTIs). Some of the typical cervical cancer symptoms are as follows:

• Abnormal or unusual bleeding between periods , after intersourse or after menopause.
• Vaginal discharge with an odor that smells different than usual.
• Pelvic pain
• Frequent urination along with pain while urinating.

When a cervical cancer is in its advanced stages some of the symptoms can be:

• Difficulty while urination along with blood
• Swollen legs
• Pain or Bleeding from rectum while defecating.

What causes cervical Cancer?

Cervical cancer is mostly associated with the  human papillomavirus (HPV).

• A long lasting infection with a certain type of HPV (human papillomavirus) can cause  cervical cancer .
• The other types of HPV can cause an infection which can be transmitted from skin to skin contact or sexually via oral,vaginal or anal exposure. 
• HPV can also be linked to other cancers such as cancer of the throat , penis, vulva, vagina, anus and rectum.

Who is at risk?

Cervical cancer is the fourth most common cancer in females and is mostly due to an infection of HPV 16 and 18 subtypes.

• It is mainly diagnosed in the age group of 35 to 44 years and 50 years of age as the average age of diagnosis. 
• This HPV related cancer has several risk factors  such as
  • smoking, 
  • usage of contraceptives for long term 
  • sexual activity from early age, 
  • unprotected sex with multiple sex partners,
  • history of STD’s and
  •  immunosuppressed state of patient.

How can cervical cancer be prevented?

The risk of cervical cancer can be reduced with two major preventive steps such as

• Taking the HPV vaccine and 
• Getting regular cervical cancer screenings. 

The chances for a better outcome of cervical cancer is when the cancer is detected in the earlier stages and treated.

When should a HPV vaccination be taken?

The Optimal time for HPV Vaccination is prior to the onset of sexual activity.

•  It can be administered as early as 9 years of age up to 26 years. 
• The earlier the better as HPV vaccine is ineffective in eliminating HPV infection that is already present in the body. 
• It should be noted that HPV vaccination individuals are not exempted from routine cervical screening strategies.
•  A HPV vaccine  , if missed earlier, can be administered till the age of 45 years. 
•  A  catch up vaccine was introduced for the women who have missed their vaccination, such as pregnant women. 
• This vaccine can also prevent the risk of developing other cancers such as vulvar, vaginal cancer in women, and keeps genital warts at bay.

What is cervical screening ?

The process of identifying or detecting and removing an abnormal tissue or cells in the cervix before a cervical cancer develops is called cervical screening. It is an effective measure in decreasing incidence and death rates from cancer.

There are several screening methods for cervical cancer such as Pap smear test ,  liquid-based cytology, the HPV DNA testing and the visual inspection with acetic acid.

Screening should begin from

• 21 years of age with cervical cytology every 3 years till the age of 29. 
• For the 30 to 65 years age group- pap test alone for every 3 years/ Primary HPV testing every 5 years/ Co testing (both pap smear and HPV testing) every 5 years are available options.
•  For people over 65 years, screening can be discontinued depending on patient life expectancy, prior screening and after discussing with physician HPV vaccination.

The combination of a cervical screening and HPV vaccination can provide the greatest protection against cervical cancer. Regular screening checkups and cervical cancer awareness campaigns are the need of the hour to decrease cervical cancer cases.