Screen, detect, treat cervical cancer

Very few women are screened for cervical cancer despite India accounting for 16 per cent of total cervical cancer cases occurring globally. This needs to change to eliminate the disease, writes Dr Rajeev Vijayakumar

As per the Globocan 2020 report, India has around 18.3% of women who are diagnosed with cervical cancer, of which North-eastern regions like Aizwal in Mizoram and Papumpare in Arunachal Pradesh have the highest number of cases. The burden of cervical cancer in India is huge as the country recorded the highest estimated number of cervical cancer deaths in 2018, according to a research paper published in The Lancet Global Health. Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. Cervical cancer is a preventable disease and if it is detected early, it can be cured with better treatments as well; yet it is the fourth most common cancer among women globally. In India, a lack of awareness about cervical cancer screening remains the biggest challenge as less than 30% of women in India aged 30-49 years have been screened for cervical cancer. According to the WHO, without taking additional action, the annual number of new cases of cervical cancer is expected to increase from 5,70,000 to 7,00,000 between 2018 and 2030. Some of the causes of cervical cancer that are often seen are:

Human Papillomavirus (HPV) infection, which is transmitted through sexual intercourse

Uneven vaginal bleeding

Spotting blood after sexual activity

Postmenopausal bleeding

Foul-smelling vaginal discharge

Discomfort in lower back and abdomen

It is advisable to consult an oncologist if any of the above symptoms are noticed.

Risk factors

Some of the major risk factors that lead to cervical cancer are:

Human papillomavirus (HPV) infection: Various strains of the human papillomavirus (HPV), a sexually transmitted infection, plays a role in causing most cervical cancer.

Smoking: It can increase the chances of cervical cancer in women as compared to the ones who don’t smoke. It creates cervical mucus inside the body which increases the chances of the fatal disease.

Weakened immune system: The virus that causes AIDS impairs the immune system and puts people at risk for HPV infections. The immune system aids in the destruction of cancer cells as well as the halting of their growth and spread.

Long-term use of birth control pills: According to research, the risk of cervical cancer increases the longer a woman uses oral contraceptives (OC), but the risk decreases if the OCs are stopped, and returns to normal many years later.

Promiscuity

A promiscuous person is likely to have multiple partners. They are usually infected with high-risk HPV strains and are at risk of cervical cancer, and studies have indicated that HPV vaccination in young girls reduces the risk of cervical cancer to a great extent. Having numerous partners for sexual intercourse affects vaginal health that may lead to pregnancy, pelvic inflammatory disease (PID), infertility, and premature delivery. In India, this topic is taboo and needs to be highlighted.
Early detection is the key to better disease management. Screening is a preventative service and different techniques have been found effective in reducing the incidence of the disease. Being able to find the diagnosis early can improve the chances of successful therapy and can prevent delays in diagnosis.

(The author is a consultant in medical oncology, haemato oncology.)