Demystifying Cervical Cancer

It may come as a shock that cervical cancer is the second most common cancer among women in both rural and urban India. Even more alarming is the fact that, despite its prevalence, awareness about the disease remains low. Cervical cancer is highly preventable and treatable if diagnosed early. While many gynecologists are well aware of this, the general public, unfortunately, remains largely uninformed.

This highlights a significant gap in communication and information that needs to be urgently addressed. Awareness about cervical cancer remains alarmingly low, and there is still much work to be done in educating the public about its prevention and early detection.

What is cervical cancer?

Cervical cancer affects the cervix, the passage connecting the womb, and can be easily examined with a speculum. However, some gynecologists may overlook this simple method, opting for scans instead, which can lead to missed opportunities for early detection. Cervical cancer is primarily caused by a persistent infection of the Human Papilloma Virus (HPV), which is transmitted through sexual contact. If the immune system fails to clear the infection, HPV can remain in the body and transform normal cells into abnormal ones, eventually leading to cancer. It’s important to note that HPV transmission is not restricted to relationships with multiple partners; it can also occur in single-partner relationships and through genital contact. This means that every woman is at risk of contracting the virus at some point in her life.

Unlike cancers like ovarian cancer, which are often diagnosed in the later stages, cervical cancer develops much more slowly. It can take decades for precancerous lesions in the cervix to progress into cancer, providing a significant window of opportunity to detect, prevent, and treat it early.

Who can get affected by it?

Women who engage in sexual activity at a younger age or have multiple partners are at a higher risk of developing cervical cancer. A weakened immune system also increases susceptibility to the disease. If a woman contracts HPV, her body can typically clear the virus within two to three years, provided her immune system is strong. However, if her immunity and nutrition are compromised, her body may struggle to fight off the virus, increasing the risk of cervical cancer.

In urban areas, factors such as a sedentary lifestyle, smoking, obesity, and poor nutritional choices can weaken the immune system, increasing the risk of cervical cancer. In rural areas, issues like malnutrition, low socio-economic status, and poverty significantly impact women’s reproductive health. Addressing these problems promptly is crucial for ensuring long-term cervical health. Many older women who haven’t been vaccinated may have avoided the disease, potentially due to a stronger immune system. Nonetheless, there is no substitute for maintaining a healthy lifestyle and proper nutrition to keep the immune system robust and effective.

How can it be prevented?

The HPV vaccine is the most effective method for preventing cervical cancer, with the potential to prevent up to 90% of cancers caused by HPV. While vaccination is a crucial preventive measure, regular screening through cytology remains an important secondary strategy in combating cervical cancer.

The vaccine is most effective when administered to girls aged 9 to 14 years, ideally before they reach menarche or become sexually active. During this age range, the immune system is highly responsive, producing a strong antibody response.

For example, a 30-year-old woman who has never been sexually active may not respond to the vaccine as effectively as a girl in the 9 to 14 age group. Additionally, administering the vaccine before age 14 requires only two doses, whereas three doses are needed if the vaccine is given after this age.

While many women may not have had access to the HPV vaccine in their early years, it’s not too late to benefit from it. The vaccine can still be administered up to age 45, though its effectiveness is greatest when given before menarche.

In addition to focusing on girls, developed countries are also promoting the HPV vaccine for boys aged 9 to 14 years, as it helps protect against cancers of the penis, anus, mouth, and throat.

Increasing awareness about the HPV vaccine is crucial to ensuring it is received during the optimal age window for maximum effectiveness. As demonstrated by the COVID-19 pandemic, prevention is primary and screening is secondary. Knowledge and open, regular conversations are key to tackling cervical cancer effectively. We must act now to make a difference!

(The writer is a Professor and HOD (OBGYN, Government Medical College Yadadri, Telangana) explains why greater awareness about this disease is the need of the hour)