What is Cervical Cancer and how to prevent it? - Dr Suman Singh, Consultant Obstetrician and Gynecologist at Birthright by Rainbow Hospital, Bannerghatta Road, Bangalore

by Priya Jadhav

Cervical cancer is caused by the human papillomavirus; it begins in the cervix which is the lower part of the uterus. Here there is an uncontrolled growth of the cells which displaces normal healthy tissue causing abnormal intermenstrual/post-coital bleeding and discharge. Ultimately it spreads to the surrounding structures leading to morbidity and death.

How big is the problem?

About every 9 minutes one Indian woman loses her battle with cervical cancer. India accounts for approximately 20% of HPV-related cancers worldwide. The mortality rate of HPV-related cancers is 60%.

Who is at risk of cervical cancer?

Becoming sexually active at a young age, those with a greater number of sexual partners, those whose partners have had multiple partners, those who smoke, have poor hygiene, who have had induced abortions, and those who have used birth control pills over a long period of time are susceptible in developing cervical cancer. Around 31 % of women are HPV positive within the first year of sexual intercourse and 50% within 3 years.

What are the signs of cervical cancer?

Early cervical cancer usually has no signs which is why screening is so important. Those who are symptomatic will have vaginal spotting or bleeding after sexual intercourse, in between menstrual cycles or after menopause and they may also have foul-smelling discharge which does not go away even after treatment.

How is cervical cancer diagnosed?

The most common screening test is the Pap smear test where the doctor will collect a sample of the cells from the cervix and send it for examination. Unfortunately, less than 5% of women are regularly getting themselves screened in India. Cervical cancer is the second most common cause of death in women after breast cancer and most affected individuals are unaware that they are infected, hence may unknowingly spread the virus.

What is HPV?

It is a small non enveloped ds DNA virus that affects the squamous epithelial cells. More than hundred types are identified of which 30 to 40 infect the genital area of women and men. The low-risk types causing genital warts are HPV 6 and 11 and the higher-risk oncogenic types causing cancer are HPV 16,18,31,33,45,52,58. These 9 serotypes may cause 55 million cases of HPV cancers and diseases in India. HPV causes more than cervical cancer. These high-risk serotypes are responsible for 98% of cervical cancer, 95% of vulvar cancer, 77% of vaginal cancer, and 73% of anal cancer.