Cervical Cancer: How to Prevent Cervical Cancer
Cervical cancer is preventable and curable if detected at an early stage (WHO, 2006). India accounts for one fifth of cervical cancer globally and 130,000 new cases are added every year and by 2025, the number of new cervical cancer cases in India is projected to increase to 226,084. It is estimated that the mortality from cervical cancer may increase from 74,118 deaths in 2002 to 132,745 deaths by 2025 (National Cancer Registry Programme 2009, WHO 2004). It accounts for nearly one-third of global cervical cancer deaths. Deaths amongst women aged 25-64 years pose a heavy economic burden on families as well as on the country (National Commission on Macroeconomics of Health, 2005).
Thus, awareness amongst health providers as well as women and quality PAP screening cum preventive services is a must. Improving nutrition of the girl child, avoiding their early marriage, restricting to single partner and improving personal hygiene ( to prevent HIV and HPV infections) and going through routine periodic health check can prevent the occurrence of the disease to a great extent. For a developing country, as per the WHO norm, all women should get at-least one PAP smear test in life time at 40 years and preferably at-least once in 3 years from the time of consummation of marriage or first sexual intercourse. If all the women between 35-65 years of age are screened at-least once in 2-3 years, the incidence will come down by 93%.
Awareness needs to be spread about the test. PAP test is highly affordable, simple and easy and just takes few minutes. Women who are diagnosed as pre-cancer with Pap smear screening test should be referred to a higher centre for specialist care so that its progression to cancer can be stopped by localized treatment with laser/LEEP/cryosurgery etc without resorting to removal of uterus. But once cancer develops, its treatment is costly and for which one require to get admitted to an advanced centre with surgery, radiotherapy and chemotherapy facilities, and they are far and few and very costly.
In western or developed countries, a routine testing for HPV virus is done now a days and testing negative for the infection is very reassuring. Cervical cancer occurs frequently amongst HPV carriers especially 16, 18 strain of HPV. Our own study showed that oncogenic HPV infection in Indian women varies in different locations. It brought out certain demographic (age. parity etc) and other life style factors on the development of abnormal cytology in Indian women.
Vaccine has been developed to prevent cervical cancer and given to women in developed countries. For countries like India cost of such vaccines can be subsidized if possible, and giving it to all women during their reproductive period or at-least to high risk group will be beneficial in long run. However, regular screening should be carried out even after vaccination.
*Input: Dr. Amit Sengupta, Senior Consultant, Obstetrics & Gynecology, Fortis Hospital, Navi Mumbai.
*Image courtesy: © Thinkstock photos/ Getty Images
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