by The Welthi Bureau | 07 FEB 2018
Cervical cancer is a slow developing cancer that starts in the lining ofthe cervix which is the lower part of the uterus (womb).Worldwide, there are approximately half a million cases of cervical cancer annually and 85% of cases occur in low- and middle-income countries. It is the second most frequent cancer among Indian women with almost 122,844 new cases diagnosed every year. Every 7 minutes one woman dies of cervical cancer of which every fourth is an Indian.
Infection of the uterine cervix with the high-risk types of HPV is necessary for the development of cervical cancer. However, this infection alone is usually not sufficient to cause cancer and additional cofactors are required for progression. There are over 100 types of the virus. The types that cause genital warts are known as low-risk HPV types (most common type 6 and 8). The high-risk types cause cancer (type 16, 18 cause 70% of the cancers). The human papilloma virus is sexually transmitted, and the possibility of contact with it increases with the number of partners a woman or her partner has had. Through regular cervical screening, the changes caused by HPV can be picked up early and any treatment needed is simple and effective. Very rarely, these changes can go on to develop into CIN or cervical cancer if they are left untreated.
Other risk factors for cervical cancer are genital infections, early onset of sexual activity, multiple sexual partners, cigarette smoking, immuno-compromisedstate and low socioeconomic status.
Cancer of the cervix tends to occur during midlife. Half of the women diagnosed with the disease are between 35 and 55 years of age. It rarely affects women under age 20, and approximately 20 percent of diagnoses are made in women older than 65. For this reason, it is important for women to continue cervical cancer screening until at least the age of 70.
Precancerous cervical cell changes and early cancers of the cervix generally do not cause symptoms. For this reason, regular screening through Pap and HPV tests can help catch precancerous cell changes early and prevent the development of cervical cancer.
Possible symptoms of more advanced disease include :
Abnormal bleeding, such as
Bleeding between regular menstrual periods
Bleeding after sexual intercourse
Bleeding after douching
Bleeding after a pelvic exam
Bleeding after menopause
Pelvic pain not related to menstrual cycle
Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
Increased urinary frequency
Pain during urination
Once diagnosed with cervical cancer the patient should consult a gynaecologic oncologist to discuss treatment options. The treatments available are surgery or radiation with chemotherapy. Early stage disease can be treated by surgery. A woman may have the option of preserving her ability to have children and to keep her ovaries if diagnosed in very early stage. For advanced cases chemoradiation is the treatment of choice. When detected at an early stage, the 5-year survival rate for women with invasive cervical cancer is 91%. About 46% of women with cervical cancer are diagnosed at an early stage. If cervical cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year survival rate is 57%.
Cancer in cervix is a preventable cancer and to reduce the risk of cervical cancer, the following measures are recommended:
Vaccination against HPV: Vaccination is available for girls and women ages 9 to 26. The vaccine is most effective if given to girls before they become sexually active.
Pap test: Pap test can detect precancerous conditions of the cervix, so they can be monitored or treated in order to prevent cervical cancer. Most medical organizations suggest women begin routine Pap tests at age 21 and repeat them every three years.
HPV test: infection with Human Papilloma virus can be detected directly in place of cervical precancerous changes via pap smear. This test can be used in women over 30 years of age and is more sensitive than Pap smear. The interval of screening can be increased to five years if HPV test is negative.
Practice safe sex. Using a condom, having fewer sexual partners and delaying intercourse may reduce your risk of cervical cancer.
To conclude, cervical cancer is a preventable and treatable condition. Prevention via vaccination, early detection via Pap smear/HPV test and timely treatment can help in controlling the disease.
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