As per Globocan 2020 report, around 18.3 per cent of women in India are diagnosed with cervical cancer, of which North-eastern regions like Aizwal in Mizoram and Papumpare in Arunachal Pradesh have the highest number of cases. The burden of cervical cancer in India is huge as the country recorded the highest estimated number of cervical cancer deaths in 2018, according to a research paper published in the Lancet Global Health.
Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.
Cervical cancer is a preventable disease and if it is detected early then can be cured with better treatment. Yet it is the fourth most common cancer among women globally, said Dr Rajeev Vijayakumar, Consultant, Medical Oncology, Haemato-oncology, BGS Gleneagles Global Hospitals, Bengaluru. In India, lack of awareness about cervical cancer screening remains the biggest challenge as less than 30 per cent of women, aged 30-49 years are screened for cervical cancer. According to WHO, without taking additional action, the annual number of new cases of cervical cancer is expected to increase from 5,70,000 to 7,00,000 between 2018 and 2030.
Some of the causes of cervical cancer are often seen to be:
Human Papillomavirus (HPV) infection, which is transmitted through sexual intercourse.
Uneven vaginal bleeding
Spotting blood after sexual activity
Foul-smelling vaginal discharge
Discomfort in their lower back and abdomen.
“It’s advisable to consult an oncologist if any of the above symptoms are visible,” said Dr Rajeev.
Some of the major risk factors that lead to cervical cancer are:
Human papillomavirus (HPV) infection – Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.
Smoking – It can increase the chances of cervical cancer in women as compared to the ones who don’t smoke. It creates cervical mucus inside the body which increases the chances of fatal disease.
Weakened immune system – The virus that causes AIDS impairs the immune system and puts people at risk for HPV infections. The immune system aids in the destruction of cancer cells as well as the halting of their growth and spread.
Long-term use of birth control pills – According to research, the risk of cervical cancer increases the longer a woman uses OCs, but the risk decreases if the OCs are stopped, and returns to normal many years later.
Multiple sexual partners– “This is one of the leading risk factors among women. They are usually infected with high-risk HPV strains and are at risk of cervical cancer, and studies have indicated that HPV vaccination in young girls reduces the risk of cervical cancer to a great extent. Having numerous sexual intercourses affects vaginal health that may lead to pregnancy, pelvic inflammatory disease (PID), infertility, and premature delivery. In India, this topic is a taboo and needs to be highlighted,” said Dr Rajeev.
Early detection is the key to better disease management
The World Health Organisation (WHO) aims to eliminate cervical cancer by 2030, for which 90 per cent of girls have to be fully vaccinated with the HPV vaccine by the age of 15; 70 per cent of women screened by the age of 35, and again by the age of 45, among several other measures to be adopted.
“Very few women are screened for cervical cancer despite India accounting for 16 per cent of total cervical cancer cases occurring globally. Screening is a preventative service and different techniques have been found effective in reducing the incidence of the disease. Being able to find the diagnosis early can improve the chances of a successful therapy and can prevent delay in diagnosis. In the rural India, some of the barriers to early screening are ignorance, fear of cancer detection, medicines, infrastructure, poverty, and illiteracy,” said Dr Rajeev.
In India, other than cancer screenings there are other tests like PAP smear screening, HIV-DNA test and several programs launched by The Ministry of Health that helps with health promotion, screening, early detection, awareness generation and promotion of a healthy lifestyle. Two healthy habits that one must follow is to quit smoking and including healthy nutrients in the diet, said Dr Rajeev.