World Cancer Awareness Month is observed every year globally, in the months of February with an intention of creating awareness and hence improving knowledge about cancers to the masses.
Cancer is a silent pandemic and a concerning public health issue in the present times. Promoting awareness helps in improving access to quality care and educating about the various risk factors, prevention strategies and benefits of screening and early detection, treatment modalities and palliative care.
On occasion of the same, it is never too late to address one of the most common gynecological cancers in India, contributing to largest burden of cancer related deaths in the country, Cervical Cancer.
Worldwide, around 6 lakh new cases and around 3.5lakh deaths occur annually.
The most common cause of this cancer is a virus – high risk human papilloma Virus (HR-HPV). This virus is sexually transmitted and hence, the cervix, being the lower end of the female reproductive organ called uterus, is at high risk of getting infected. This virus cause a variety of ano-genital and head and neck cancers in both men and women.
70% of all adults will be infected by HPV once in their lifetime. As the infection shows no symptoms, it goes unnoticed. 90% of the infected population will have a spontaneous resolution in 1-2years. The remaining 10% will continue to have a persistent infection which eventually leads to abnormal changes in the cells of cervix and end in pre-cancer stages which progresses to cancer, if not detected early.
The various risk factors are the major contributors to a HPV infection, like intercourse at a young age, multiple partners, multiple pregnancies, prolonged birth control pill usage, other STIs, immune suppression, poor personal hygiene, smoking etc..
Majority of the patients remain asymptomatic in early stages. Symptoms like abnormal vaginal bleeding, post-coital bleed, abnormal/persistent foul odoured vaginal discharge, pelvic pain, leg swelling, bowel/bladder complaints, leakage of urine/stool per vagina, fatigue, loss of weight etc, are a few symptoms that occur as the cancer advances.
The good news being, this dreaded cancer is preventable!
Though HPV infection has no treatment, vaccines against HPV, helps in preventing infections and also efficacious in reducing the pre-cancer and cancer rates. Both, females and males are eligible for vaccination, though the ideal age to be vaccinated is before the exposure to the virus, i.e., between 9-14years, catch up vaccination is offered between 15-45y.
You can reduce the risk of cervical cancer by getting regular screening with pap and/or HPV DNA test, All women, starting as early as 21y, up to 65y, can get screened, once every 3 -5y based on the method of test used. Recently, self-sample collection is also feasible.
As the early stages might not show any signs and symptoms, getting screened at timely intervals help in early detection of pre-cancer and cancer lesions. Cervical cancer is one of the most successfully curable malignancies when diagnosed and treated in the early stages. Thereby, emphasizing the need for such tests.
The mode of treatment varies with the stage and type of disease. Treatment options include surgery, radiation, chemotherapy or a combination of these. The likelihood of the treatment being successful is very high as long as the cancer is contained within the cervix.
Constant efforts to raise public awareness and increase vaccination and screening rates will help in reducing the incidence and also earlier detection and improved survival. Australia has the least number of cancer cervix due to their strict adherence to these prevention protocols. The introduction of the indigenously developed HPV vaccine – CERVAVAC by Serum Institute of India, will be a game changer in fighting this pandemic.
Views expressed above are the author’s own.
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