Cervical cancer is the second most common cancer in Indian women after breast cancer. Every year, 96,922 women are diagnosed with cervical cancer in India and 60,078 die from the disease (GLOBOCAN 2018). Here are some facts about this cancer, how you can prevent it, and the treatment modalities.
Cervical Cancer Facts
- Cervical cancer occurs when cells of the cervix (the lower part of the uterus, which connects the body of the uterus to the vagina), grow out of control.
- Symptoms include irregular vaginal bleeding, bleeding in between periods or after sexual intercourse, postmenopausal bleeding and foul smelling vaginal discharge. Some women may also experience low back pain or lower abdominal pain.
- Nearly all cases of cervical cancer can be attributed to persistent Human papillomavirus (HPV) infection. This is an infection which is present in almost all sexually active adults and is generally cleared off by the body. In a few individuals, however, the infection persists, and if not screened, can lead to precancerous and cancerous lesions of cervix. Other risk factors for cervical cancer include early age at marriage, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, smoking, immunosuppression including HIV infection, and prolonged use of oral contraceptives.
Importance of Cervical Screening
A major cause of high incidence of cervical cancer in India, is the lack of awareness of this disease and the lack of cervical screening. Screening can find changes in the cervix before cancer develops. It can also find cervical cancer early – when it has not spread, and is amenable to curative treatment. Because of paucity of screening, many cases of cervical cancer are detected in advanced stages leading to high mortality rates.
How can you protect yourself against cervical cancer?
Consult your gynecologic oncologist or gynecologist, who will do a thorough pelvic examination and tell you about the tests used for cervical screening - Pap test and HPV DNA test. Women aged 21 to 29 years, should have a Pap test every 3 years. From the age of 30, the preferred way to screen is to get tested every 5 years with a Pap test combined with an HPV test (co-testing), OR every 3 years with a Pap test, till the age of 65.
If the Pap and/or HPV tests are abnormal, you may be advised further evaluation, which may include colposcopy (a procedure to examine an illuminated, magnified view of the cervix) along with a biopsy, followed by management according to the results.
Diagnosis and Management
Diagnosis of cervical cancer involves a complete physical examination and a cervical biopsy wherein the doctor takes a small biopsy from the cervical growth to confirm malignancy. In addition, radiological imaging (MRI/CT/PET-CT) is advised to look for the spread of the disease, if any.
The Cancer treatment depends upon the stage of the disease. Patients with early stage of cancer and in good general condition are advised surgery, in which the uterus and cervix with the neighbouring tissues are removed (radical hysterectomy) along with the lymph glands in the pelvis. Patients with advanced stages of cancer are treated with radiotherapy with or without chemotherapy.