Among the many cancers that Indian women succumb to every year, cervical cancer takes the second place after breast cancer. Annually, about 75,000 women are diagnosed of it and nearly 25% of them succumb to it. Lack of awareness and late diagnosis and treatment are a major cause for the fatality.
Prevention
Many women in India don’t want to believe that they too can be affected by cervical cancer. The good news is that a simple human papilloma virus (HPV) vaccine can prevent them from getting affected by the deadly condition.
When administered between ages 9 and 11, the vaccine reduces risk of the cancer by 93%. Among older women, the vaccine reduces the chances by 70 to 80%. One has to take three shots to make sure the body develops immunity. Pregnant women must avoid taking the vaccine.
It is recommended as a routine vaccine by the World Health Organisation in the countries that can afford it. It is given in 58 countries across the world as in 2014. The vaccine also prevents genital warts which are caused by HPV 6 and 11.
Causes
Human papilloma virus is a proven cause of cervical cancer. It is present in the mouth, anus, genital areas and nasal cavity. It is the most common virus present in humans worldwide. Out of the 100 kinds of HPV viruses present on earth, 13 are cancerous. Of these, type 16 and 18 cause 70% of cancers. The virus is estimated to be present in 75% of the population that is in reproductive age.
Who is at risk?
A woman can contract cervical cancer when she suffers wounds in her cervix during labour. The virus can also be sexually transmitted. Having multiple partners increases the risk of contracting the virus. Skin-to- skin genital contact can also transmit HPV. Smoking, which affects our body’s immune system, also leads to cervical cancer.
Human papilloma virus is present in higher quantities in men. The virus starts acting immediately after it gets in touch with a body. Sometimes, it dies if the immune system of the body is efficient, while in other cases, it might stay for a longer time and become cancerous.
A woman with a normal immune system takes about 15 to 20 years to develop cervical cancer, compared to those with weak immune system who only take five to 10 years.
Symptoms
Some of the symptoms of cervical cancer appear only after it reaches an advanced stage. They include irregular, abnormal vaginal bleeding after sexual intercourse, back, leg or pelvic pain, fatigue, weight loss, loss of appetite, vaginal discomfort or odorous discharge and single swollen leg. During the advanced stages, women may see symptoms that are more severe.
Detection
Once a woman sees any such symptoms, it is recommended that she visit a health care centre for a pap smear test. During this test, a sample of the discharge from the cervix is taken and examined. Another test called colposcopy, which checks cells for unusual behaviour, can also be done. Unfortunately, acceptance of this vaccine is less in India. Only 3% of the women in India undergo a pap smear test in their lives.
Early education
Educating people about safe sexual practice is important. The younger generation must be warned about the use of tobacco which can cause cervical as well as other cancers. Male circumcision (removal or foreskin) can also help.
(The author is consultant obstetrician & gynaecologist, Fortis Hospital, Bengaluru)
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