Cervical cancer - the second most common cancer in women

This article narrates about the cervical cancer, HPV testing and HPV vaccination. The cervical cancer is the fifth most common cancer in humans, the second most common cancer in women worldwide and the most common cancer cause of death in the developing countries. Sexually transmitted human papilloma virus (HPV) infection is the most important risk factor for cervical intraepithelial neoplasia and invasive cervical cancer . The worldwide incidence of cervical cancer is approximately 5,10,000 and new cases annually, with approximately 2,88,000 deaths worldwide. Unlike many other cancers, cervical cancer occurs early and strikes at the productive period of a woman's life. The incidence rises in 30–34 years of age and peaks at 55–65 years, with a median age of 38 years (age 21–67 years). Estimates suggest that more than 80 per cent of the sexually active women acquire genital human papilloma virus by 50 years of age. The current estimates indicate approximately 1,32,000 new cases diagnosed and 74,000 deaths occur annually in India, accounting to nearly 1/3rd of the global cervical cancer deaths. “Cervical cancer can have devastating effects with a very high human, social, and economic cost, affecting women in their prime. But, this disease should not be a death sentence, even in poor countries,” explains Dr Rengaswamy Sankaranarayanan, a leading investigator for an IARC research project with a focus on cervical cancer screening in rural India. “Low-technology and inexpensive screening tools exist and could significantly reduce the burden of cervical cancer deaths right now in less developed countries.”

Cervical cancer is the easiest female cancer to prevent, with regular screening and follow-up. It is established that well-organised cervical screening programmes or widespread good quality cytology can reduce cervical cancer incidence and mortality. The two tests can help prevent cervical cancer or find it early.
1) The Pap smear helps find pre-cancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. Women should start getting the Pap test at the age 21 years, and then every three years after that.
2) The human papilloma virus test checks for the virus that can cause these cell changes on the cervix. It may be used to screen for cervical cancer, with the Pap test, in women aged 30 years and above. If both tests are negative, the risk for cervical cancer is very low and women can wait five years before another screening. The human papilloma virus tests also may be used to provide more information when a Pap test has unclear results.

Getting the human papilloma virus test with the Pap test at the same time can safely increase screening intervals up to 5 years for women who do not have human papilloma virus and have a normal Pap test result, and SRL offers a panel with human papilloma virus DNA detector and Pap smear examination.

There are other tests like the Fish Test and the Cervix Biopsy, though these are reserved for a later stage. Though there are several methods of prevention of cervical cancer, prevention by vaccination is emerging as the most effective option, with the availability of two vaccines. The introduction of human papilloma virus vaccination could also effectively reduce the burden of cervical cancer in the coming decades.

The vast majority of deaths from cervical cancer occur in low- and middle-income countries, where vaccines and screening aren’t widely available. As a step towards fostering a wellness-oriented culture that is based on conscious and preventive healthcare, SRL Diagnostics is encouraging women to get vaccinated against the human papilloma virus.

Human papilloma virus types 16 and 18 are responsible for about 70 per cent of all cervical cancer cases worldwide. HPV vaccines that prevent against human papilloma virus 16 and 18 infections are now available and have the potential to reduce the incidence of cervical and other cancers.

The Centers for Disease Control and Prevention (CDC) recommends the cervical cancer vaccination for girls and boys at the ages 11 to 12, through the age 26. It's important for girls and boys to receive the vaccine before they have sexual contact and are exposed to human papilloma virus. Once infected with human papilloma virus, the vaccine might not be as effective or might not work at all. Also, response to the vaccine is better at younger ages than it is at older ages.

Human papilloma virus vaccines are to be given as a series of three injections over a six-month period. The second dose is given one to two months after the first dose, and the third dose is given six months after the first dose.

Pap smear examination is already recommended to be a part of annual health checks. It is also advisable to add human papilloma virus examination along with the Pap test. This is called human papilloma virus co-testing. Screening tests can find early problems before they become cancer. That way, problems can be found and removed before they ever become cancer.