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WHAT IS CERVICAL CANCER?

Cervical cancer is a cancer of the cells of the cervix, which is the entrance to the womb from the vagina. Cervical cancer is the second most common cancer among women in India and the fourth most common worldwide. It has been roughly estimated that one woman dies every 8 minutes due to cervical cancer in India.

WHAT CAUSES CERVICAL CANCER?

This infection is caused by the human papillomavirus (HPV), which is the most common cause. It is a sexually transmitted viral infection and the most important causative factor for cervical cancer. It is believed that almost 75% of adults are infected by at least one type of HPV. However, not all women with an HPV infection will develop cervical cancer. In majority of people with healthy immune system, the body can spontaneously clear the infection. Sometimes, in a very small proportion of women, the infection does not go away and remains persistent. This chronic infection, especially by a high-risk subset of human papilloma virus (HPV), can cause precancerous changes in cells and ultimately progress to cervical cancer. The risk factors include:

  • Early age of sexual intercourse
  • Multiple sexual partners
  • Multiparity/ given birth to three or more children
  • Co-existing conditions such as AIDS
  • Smoking

WHAT ARE THE SYMPTOMS OF CERVICAL CANCER?

Cervical cancer may present itself with vague symptoms such as weight loss, loss of appetite, pelvic pain, painful micturition or specific ones such as:

  • Bleeding after menopause
  • Bleeding between regular menstrual periods
  • Bleeding after sexual intercourse
  • Abnormal vaginal discharge

Symptoms listed do not definitively point to cervical cancer but may have other causes not related to it. However, should you experience any of them and are worried, do GP video consultation online at the earliest.

HOW CAN CERVICAL CANCER BE TREATED?

Staging the cancer based on the tumor size and the extent of its spread, is an important first step because as it highly influences the treatment and prognosis. Modalities commonly employed in treatment are:

  • Surgery.
  • Radiotherapy, which uses high-energy radiation to kill cancer cells.
  • Chemotherapy involves the usage of drugs to shrink tumors and stop them from growing.
  • Hormone therapy.

Fortunately, vaccination and screening may together lead to a greater reduction in the risk of cervical cancer.

HPV Vaccine: Vaccines are developed targeting HPV types 16 and 18. The most common oncogenic types of HPV, which together are responsible for approximately 70% of cervical cancer cases.

The recommended age for initiation of vaccination is 9-14 years. Ideally, patients should be vaccinated before onset of sexual activity. As of current regulations in India, catch up vaccination is permitted up to the age of 45 years, although the efficacy of the vaccine seems to wane with increase in age.

Screening: Regular screening through Pap smears starting at the age of 21 along with HPV DNA testing as per schedule look for changes on the cervix that may progress to cervical cancer, if not treated appropriately. Vaccination and screening may together lead to a substantial reduction in the risk of cervical cancer.

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