Cervical Cancer Screening: What women should know?

India has a population of 483.5 million women aged 15 years and older. All of whom are potentially at risk of developing cervical cancer. It is estimated that every year more than 1, 20,000 women are diagnosed with cervical cancer in India and more than 77,000 women die from the disease. Cervical cancer ranks as the 2nd most frequent cancer amongst women in India with breast carcinoma being the commonest cancer in Indian women. Screening tests play a significant role in the early detection of cervical cancer and precancerous cells. These precancerous cells have the potential to develop into cancerous cells causing cervical cancer. The key to reducing cervical carcinoma lies in early detection when treatment works best. International screening recommendations suggest beginning screening at the age of 21yrs. Both breast cancer and cervical cancer account for a significant cancer- related mortality in Indian women. These deaths are preventable with access to information, high quality care, and regular screening tests with follow-up. Unfortunately only 1 in 10 women were screened for cervical carcinoma in the past 5 years. This needs to change. Most international societies have a broad consensus related to cervical cancer screening and the guidelines below may help make an informed decision

1. Cervical cancer screening should begin at the age of 21, regardless of sexual history of an individual
2. For women aged between 21 and 29 years, a cervical smear cytology commonly known as a PAP test is recommended every 3 years
3. For women who are 30 years or above, co-testing with PAP and Human Papilloma Virus (HPV) is recommended every five years, HPV screening alone every 5 years or a PAP test alone every 3 years
4. Cervical cancer screening can be discontinued at age 65 in women who have had 2 successive normal co-test results or 3 consecutive normal Pap test results in the past 10 years, with a test resulting normal in the last five years

The specific strategy selected is less important than consistent adherence to screening guidelines with inadequate cervical cancer screening remaining a significant problem even in developed countries. There is a perception that cervical cancer screening can be stopped once an individual has had children. This has no scientific basis and it needs to be stressed that it is important to continue to follow the screening guidelines. Similarly women who have been vaccinated against HPV (Human Papilloma Virus) should also follow these screening guidelines. Those women who have had a total hysterectomy with removal of the cervix need to discuss with their doctor as cervical cancer screening can stop if the hysterectomy was not related to cervical cancer or a high grade precancerous lesion. Vaginal bleeding post intercourse, bleeding after douching, pain in the pelvis are some of the symptoms of cervical cancer. Others include weight loss, fatigue, painful urination, vaginal discharge with a strong odor, vaginal discharge tinged with blood etc.  To make a diagnosis of cervical cancer, your doctor will visually examine the cervix and take a tissue sample for biopsy and examination by an expert pathologist under the microscope. If the lab results suggest cancer, your doctor will order more tests to determine if the cancer has metastasized, which indicates that the cancer may have spread to other organs of the body. The WHO in 2018 also launched a cervical cancer elimination initiative that has the 90-70-90 targets for all countries to reach by 2030. This includes vaccinating all eligible girls with the HPV vaccine by the age 15, screening 70% of women at 35 and 45 and treating 90% of women with pre-cancer and managing 90% of women with invasive cancer. Cervical cancer prevention, screening, and treatment are critical constituents of comprehensive reproductive health care. Large scale awareness programs in every state at a district level and population-based screening through public-private partnerships can help India reduce the burden of cervical cancer. It is time for women to take charge of their health and go for cervical cancer screening themselves and for us to increase awareness amongst others. We need to move forwards with multi-sector collaboration, advocacy and communication partnerships.  Eliminating cervical cancer is within our reach; the script needs to be rewritten.

• Source: https://hpvcentre.net/statistics/reports/IND_FS.pdf

The author is Dr Abha Sabhikhi, Technical Advisor at SRL Diagnostics. Dr. Abha has over 34 years of experience in pathology and is a senior oncopathologist. Read all the Latest News , Trending News ,  Cricket News , Bollywood News , India News and Entertainment News here. Follow us on Facebook, Twitter and Instagram.