New Delhi: Cancer is a subject of enormous complexity, it is one many dread to talk about. It is one of the leading causes of adult deaths worldwide. Every year about 14 million new cancer cases are detected and 8 million people die of cancer.
One can explains cancer as the uncontrolled growth of body cells that can start almost anywhere in the human body. But when a cancer develops in the cervix of female then it is termed as cervical cancer or cancer cervix.
Cervix is called as the lower part of the uterus which connects the body of the uterus to the vagina (birth canal). The lower part of the cervix called as ectocervix, lies within the vagina whereas the upper two thirds of the cervix called as endocervix, lies above the vagina. It is believed that most cervical cancers originate in the area where the endocervix and ectocervix joins.
Cervical cancer is the fifth most common cancer in humans and the second most common cancer in women worldwide. In contrast to developed countries, cervical cancer is a public health problem in developing countries like India so much that, India alone accounts for one-quarter of the worldwide burden of cervical cancers which is approximately 6–29% of all cancers in women among the age of between 30 and 69 years.
According to a report by Spain-based international public health institution, it is estimated that cervical cancer will occur in approximately 1 in 53 Indian women during their lifetime compared with 1 in 100 women in more developed regions of the world.
Cause of Cervical Cancer:
Cancer of the cervix tends to occur during midlife. The cancer mostly affects middle-aged women (between 40 and 55 years), especially those from the lower economic status who fail to carry out regular health check-ups due to financial inadequacy. It rarely affects women under age 20, and approximately 20 percent of diagnoses are made in women older than 65.
Nearly all cases of cervical cancer can be attributable to genital Human Papilloma Virus (HPV) infection. This infection is mostly spread through sexual contact or skin-to-skin contact.
HPV is defined as a group of viruses and is one of the causative agents in the sexually transmitted infections (STIs) in men and women with and without clinical lesions. Therefore one can say that, HPV transmission is influenced by sexual activity and age.
Basically, there are over 100 types of HPV, but only 40 will affect the genital tract. And only about 15 of these 40 types affect the genital tract that causes cancer.
Although, HPV is a necessary cause of cervical cancer, but it is not a sufficient cause. Other cofactors are long-term use of hormonal contraceptives, high parity, multiple sex partners, early initiation of sexual activity, tobacco smoking, poor hygiene, diet low in antioxidants and co-infection with HIV have been identified as established cofactors.
Cervical Cancer Symptoms that Every Woman Needs to Know:
1. Pelvic pain not related to your menstrual cyccycl
2. Heavy or unusual discharges that may be watery, thick, and possibly have a foul odor,
3. Increased urinary frequency
4. Pain during urination and
5. Also abnormal or irregular vaginal bleeding such as bleeding between regular menstrual periods, bleeding after sexual intercourse, douching, a pelvic exam and menopause etc.
HPV Vaccination:
Expert says that, HPV types (16 and 18) cause 70% of cervical cancers but this is a cancer that is both preventable through vaccination and regular testing and treatment. HPV vaccination is recommended for both male and female, and women sometimes irrespective of their age, to get vaccinated against the virus that causes cancer. There are vaccines licensed globally for protection such as-
1. Gardisil, which protects against HPV strains 6, 11, 16, and 18
2. Cervarix, which protects against HPV 16 and 18
3. Gardisil 9, which protects against HPV 6, 11, 16, 31, 33, 45, 52, and 58
HPV vaccination and regular cervical screening is the most effective way to prevent cervical cancer.
The World Health Organization (WHO) recommends the vaccine for all girls between 9 and 13 years, because the vaccine is highly immunogenic at this age. Only two doses of the vaccine administered at a 6 to 12 month interval are enough to protect girls less than 15 years of age. And older than 15 years, as well as those who are immuno-compromised (e.g., living with HIV) require 3 doses of vaccine.
Also, other than Vaccination, there are two preventive strategies for cervical cancer that includes screening and vaccination. According to internationally accepted protocol, all women of 25-64 years need to undergo screening every three years but report says that just 3.1% women in India get screened. Unfortunately in India, Cervical cancer is not seen as a priority by the government even after knowing that one-fourth of cervical cancer deaths occur in India.
Cervical Cancer Precautions:
1. Get the HPV vaccination
2. Eat fruits, beans, whole grains and vegetables like cauliflower, broccoli, and other relatives each day. They can aid in the restoration of the cells infected with HPV.
3. Smoking cigarettes has been shown to cause many different types of cancer—including cervical cancer. Quit smoking and even avoid coming in contact with second-hand smoke.
4. Consult your doctor for the Pap smear test as it can detect early cervical changes long before the cancer actually begins to develop.
Cervical cancer as a major killer among Indian women overtakes the breast cancer deaths in last two-three years. According to last data estimates by Indian Council of Medical Research (ICMR), over 62,000 women died of cervical cancer in 2015, accounting for 24% of the total cancer-related deaths of women in India. And on an average, India reports about 122,000 new cases of cervical cancer annually, with around 67,500 women succumbing to the disease.
In today's era, in spite of the availability of HPV vaccines with affordable and effective methods of early detection and treatment; cervical cancer is still continues to be a public health problem in India.
The fight against cervical cancer has been a long one. There exist some cultural and economic challenges that one must recognize in relation to cervical cancer. Despite, there is a vaccine available that helps to prevent cervical, its usage remains limited due to its high costs and concerns about its efficacy and long-term safety.
Dr. Ritu, a gynecologist from Gurgaon says that, " To prevent cervical cancer, govt should look upon to improve the access to - screening and education programmes related to it. As vaccination for Cervical cancer is just a part of the solution and one should not fall into the trap that if we use the vaccine, our burden will be lessen because the fact is; vaccine only covers a number of viruses but not all viruses related to cervical that may be caused by some other factors.”
Recently, India has a population of approximately 365.71 million women above 15 years of age, who are at risk of developing cervical cancer as it is ranked as the most frequent cancer in women in India.
References:
1. www.tribuneonlineng.com
2. www.prnewswire.com
3. www.health.com
4. www.cancer.org
5. www.disability-benefits-help.org