World Cancer Day 2019: Cervical cancer can be prevented, even cured if found early
India has a population of 365.71 million women over age 15 who are at risk of developing cervical cancer.
Cancer is the second leading cause of death globally after cardiovascular disease. India has a population of 1·3 billion spread across 29 states and seven union territories, many of which are as large as some countries in the world.
With varying degrees of development, population genetics, environments and lifestyles have led to a heterogeneous distribution of disease burden and health loss. Together, breast cancer and cervical cancer are the largest growing cancers in women worldwide, and second-most common cancers among women in India. These cancers can be easily diagnosed today, and are considered an age-old disease that is now killing more and more young people. Sadly, the only solution to cutting our losses is early diagnosis and treatment.
Prevention is better than cure
This phrase was drilled in my mind as a young medical student. In fact, in medical colleges, we study normal anatomy, normal functioning of the body for the first 1.5 years before embarking on preventive medicine and other diseases.
Interestingly, Australia was the first country in the world to introduce mass cervical cancer vaccine or a Human Papilloma Virus (HPV) vaccination scheme for girls in 2007. The programme was later extended to boys, too. The new modelling was published recently by the Cancer Council New South Wales (NSW), a charity, in The Lancet Public Health journal and followed up with a discussion on BBC news.
The disease can be eradicated as a public health issue nationally in 20 years' time, according to new statistics. It is predicted to be classified as a "rare cancer" in Australia by 2022, when it should drop to less than six cases for every 100,000 people. Scientists attribute this progress to the national prevention schemes. Clearly, it is one of the best cases of preventive medicine and public health initiatives at work in preventing cancer.
How cervical cancer manifests
India has a population of approximately 365.71 million women above 15 years of age, who are at risk of developing cervical cancer.
At any given time, about 6.6 percent of women in the general population are estimated to harbor cervical HPV infection. Some of the common symptoms of cervical cancer are abnormal bleeding and women with cervical cancer may experience abnormal vaginal bleeding. An increased discharge from the vagina is also a symptom of cervical cancer. It may be foul smelling, watery, thick or contain mucus. Similarly, pain during urination can be a symptom of advanced cervical cancer, and so can unexpected bleeding between regular menstrual periods, after sexual intercourse, or during a pelvic exam. This happens because the cervix is irritated during these activities.
The cervix, which is the mouth of the uterus, can be examined for cancer with a pap smear test — a simple test performed by the gynaecologist to detect early pre-cancer changes.
Fully-preventable & treatable if found early
However, cervical cancer can be fully prevented, and treated if diagnosed on time. The treatment for cervical cancer depends on the size and location of the tumor, the stage of the disease, and the patient’s age and overall health. Cervical cancer, most often, can be treated with one or a combination of treatments; surgery, radiation, and/or chemotherapy.
Cervical cancer is preventable, too, if all young females are vaccinated against HPVs and if any precancerous lesions () are reported, screened and treated by a doctor.
In addition, if cervical cancer is detected early and treated in earlier stages it can be cured. According to a recent reports, most women are not doing their own tests for screening cervical cancer. The advice is that this cancer should not be ignored and should be treated immediately. There still exists a taboo in women about "screening", which is something that needs to be addressed in the larger interest of the society.
Eight in ten women who are diagnosed, and nine in ten women who die from cervical cancer live in a low- or middle-income countries. The reasons for this isn't a mystery at all. Most patients come to treatment facilities when they are in advanced stages and, therefore, are at a higher risk of dying from the disease. Of those who seek treatment, many do not receive or complete it because it may not be commonly available or may be expensive and unaffordable.
While we need to step up our efforts to generate and collect accurate sample data, we also need to set up and scale up cost-effective, socially-acceptable programmes to prevent, detect and treat cervical cancers early.
The author is a practising neonatologist at Cloudnine Group of Hospital, visiting Professor at Indira Gandhi Institute of Child Health, Bangalore and an Adjunct Professor of Neonatology at Notre Dame University, Perth, Australia. He is also the National coordinator, Accreditation Committee, National Neonatology Forum, and the views expressed in the article are personal.
myUpchar had the opportunity to chat with leading orthopaedic oncologist Dr. Vivek Verma to discuss his experiences in this field.
Some countries also recommend the shot for boys, to eliminate the HPV virus from circulation.
Cervical cancer is the fourth most common cancer as well as the fourth leading cause of cancer deaths in women worldwide.