Come January, it not only marks the beginning of a new year with new resolutions, but also reminds us about the awareness for cervical cancer. While developed nations have almost won their battle against cervical cancer, developing nations like India are still lagging. In 2018, 60078 deaths (20 percent of world mortality) and 96922 new cases have been reported making it the 3rd most common and 4th deadliest cancer in India. (Ref: Globocan 2018, International Association of Research in Cancer, IARC, WHO)
So, Indians, its high time you should put behind shame and superstitions and make yourself and others aware of cancer which is not only completely preventable but also curable.
What is the cause of cervical cancer?
Almost 90% of cervical cancer is caused by high-risk HPV (Human Papilloma Virus) infection. HPV is commonly found in vaginal flora of women, but most healthy women clear it off. But there are some risk factors which results in persistence of infection and this causes some oncogenic changes in the cervix resulting in cervical cancer. The risk factors are:
1. Poor Hygiene
2. Multiple sex partners
3. Prolonged use of Oral Contraceptive Pill
4. Smoking
5. Increased number of child births
6. Co-existence of HIV infection
Is there any measure you can take to prevent from acquiring cancer?
Screening: The WHO recommends screening of women aged 30 to 49 years either through visual inspection with acetic acid (VIA) in low resource setting or by conventional PAP smear testing every 3-5 years. In higher centres. HPV virus testing is also available to be done every 5 years. In United States and United Kingdom, screening is recommended much earlier, 21 years and should continue till 60-65 years.
Vaccine: Vaccines are also available against high-risk HPV viruses. 3 doses to be given to school going girls of 9-13 years to achieve maximum immunity. But vaccines will not provide complete immunity.
Thus, the integration of both screening program and vaccination has the potential to virtually eliminate the burden of cervical cancer
What Precautions can you take to prevent occurrence?
Better hygiene, use of barrier contraceptives during intercourse, avoid multiple sex partners, refrain from smoking are few simple steps that will prevent the cancer to happen.
What is the available treatment?
Pre-cancerous lesions of cervix can be managed by Colposcopy guided ablative or excision procedures done at OPD basis. Treatment of Invasive Cervical Cancer depends on the stage of the disease. For early stages surgery is recommended. Radical hysterectomy with pelvic node dissection is surgery of choice. Can be done by open, laparoscopic or robotic techniques. For locally advanced cases radiation therapy is recommended. For distant metastasis treatment option is palliative chemotherapy where we only alleviate the symptoms of the patient.
How good/ bad is the prognosis?
Survival is very good compared to other female cancers.5-year survival for Stage 1 its almost 80-90%. For Stage 2 its 60-70%, Stage 3 its 40-50% and even for Stage 4 (last stage) its almost 30%.
Cervical cancer is the only female cancer which is not only completely preventable but also completely curable in early stages. So, you should spread this word. Your one word will save thousands of innocents dying women.
Dr. Kaustav Basu
DGO, DNB, MNAMS, FMAS, Fellowship in Gynaecology Oncology
Consultant Gynaecologic Oncosurgeon
Narayana Superspeciality Hospital, Howrah
