Is Ignorance & Inhibition Stopping Women from Getting Screened For Cervical Cancer?

  • 6 mins read
  • Health Conditions
  • Women's Health
  • Reshma Pathare, Health Journalist
cervical cancer prevention
  • Cervical Cancer is the most diagnosed in women between the ages of 35 to 44. However, becoming sexually active at a young age (especially, before 18 years), increases the risk of getting afflicted earlier.
  • 99% of Cervical Cancer cases are linked to infections caused by human papillomaviruses (HPV), a high-risk type of virus that is commonly spread through sexual contact.
  • Cervical Cancer-causing HPVs are transmitted not just through penetrative sex, but also through skin-to-skin genital contact.
  • As per a 2020 report by the Asian Journal of Pharmaceutical Research and Health Care, the incidence and mortality of Cervical Cancer in Southeast Asia ranked in the top three of Asian regions.
  • WHO reveals that lack of access to screening, prevention, and treatment of Cervical Cancer contributed to 90% of female deaths in sub-Saharan Africa in 2018. The burden continued to remain high even in 2020, as affirmed by the British Journal of Cancer.
  • According to the 2021 report by HPV Information Centre, every year around 1407 women in Sri Lanka are diagnosed with Cervical Cancer; approximately, 780 die due to the same.
  • HPV Information Centre’s 2021 report states that Cervical Cancer is the 2nd most frequent cancer for women in Malaysia between the ages of 15 to 44.
  • Among women in Vietnam, HPV 16 or 18 are the cause of 82.8% of invasive Cervical Cancers.
  • Active as well as passive smoking elevates the risk of getting afflicted with Cervical Cancer.
  • Weak or compromised immune system can lead to Cervical Cancer.
  • Cervical Cancer is one of the most easily detectable female cancers, and can be detected via a simple Pap Smear Test.

What is Cervical Cancer?

To understand what is Cervical Cancer, let us first understand what is a Cervix. A cervix is a narrow passageway that connects a woman’s uterus with her vagina. Cervical Cancer occurs in the cells of the cervix.

Sexually-active women above the age of 30 are at most risk of contracting Cervical Cancer, due to the Human Papillomavirus aka HPV that is commonly transmitted during sexual intercourse. Of course, other factors like being HIV-affected, having multiple sexual partners, being sexually active from a younger age, using birth-control pills for a prolonged period, and smoking, also put women at risk of contracting this cancer.

Statistically speaking

  • According to the World Health Organisation (WHO) – Cervical Cancer Country Profile 2021 reports, around 18.7% of a sample size of 100,000 women in India, were affected by Cervical Cancer in 2020. However, less than 1 out of 10 women had been screened for Cervical Cancer in the last five years.
  • The rate of testing was the same for women in Central African Republic, where the incidence of affected women in 2020 was 12.2% per 100,000 women.
  • WHO also revealed that Cervical Cancer accounted for 12% of all the major cancers affecting women in 2020. Countries like Philippines and Thailand had as high as 14.5% and 25.6% among every 100,000 affected by this disease.

Early warning signs of Cervical Cancer

It is easy to let Cervical Cancer go undetected, simply because its initial symptoms are very vague. In fact, the pre-cancer stage may not show any symptoms at all, and it could take up to the early stages of the cancer setting in before the warning signs begin to pop up.

Some of the early warning signs of Cervical Cancer include:

  • pain during sexual intercourse
  • foul-smelling watery or bloody or heavy vaginal discharge
  • heavier-than-usual bleeding during menses
  • bleeding after sexual intercourse or pelvic examination
  • sudden back pain or pelvic pain

The best way women can ensure that they do not become a victim of Cervical Cancer, is to immediately consult their doctor if they notice one or more of these symptoms.

Are you at risk for Cervical Cancer?

Not many are aware that smoking causes Cervical Cancer. That is because, smoking suppresses the core immunity that helps stem the growth of HPV, the main cause of Cervical Cancer. In fact, weak immunity is a major factor in making women prone to Cervical Cancer.

A report by WHO has observed that while it may take around 15-20 years for Cervical Cancer to develop in women with normal immune systems, those with a weak immune system can get prone to the disease in just 5-10 years.

Apart from smoking, chances of Cervical Cancer increase if a woman has been sexually active from a young age and/or is sexually active with multiple partners. Being co-infected with sexually-transmitted diseases like chlamydia, herpes simplex or gonorrhea also increases the risk of getting afflicted by Cervical Cancer.

Further, birth control pills and cervical cancer are revealed to have a close connection as well. While prolonged usage of oral birth control pills reduces the risks of Uterine Cancer and Ovarian Cancer, it increases the risk of getting afflicted by Cervical Cancer. That’s because, oral contraceptives can make cervical cells susceptible to infections by high-risk HPVs, which are a major reason for Cervical Cancer setting in.

If you’re into smoking, or taking oral contraceptives for a prolonged period, or have been sexually active with multiple partners, it becomes doubly important to get yourself screened well in time.

Prevention and control of Cervical Cancer

As is true for any ailment, paying attention to the warning signs, and going for regular testing to aid timely detection of Cervical Cancer can go a long way in preventing and arresting the disease, respectively.

However, it is commonly seen that women do not opt to get tested for cervical cancer screening, primarily due to two main factors: ignorance and inhibition. A large number of women feel that they’re not vulnerable to Cervical Cancer simply because they don’t have a family history of cancers. They feel that screening is necessary only for women who show primary symptoms. However, this is a fallacy.

Then, there are an equally large number of women who feel shy or are afraid to approach their doctor to get the screening done, even though it is just a simple swab test.

All these factors only increase the risk for women getting afflicted with Cervical Cancer. The best way to avoid it, is to go to the doctor and get the simple screening tests done well in time.

Common Cervical Cancer screening methods

Cervical Cancer is best detected in early or precancer stage by two uncomplicated screening tests that takes as little as 10 minutes: the Pap Smear Test and the HPV Test.

The Pap Smear Test

The Pap Smear Test is done by collecting cells from the cervix with a simple swab. The cells are tested under a microscope to see if there is any presence of the cancerous cells.
A commonly asked question is, what is the best time to do a Pap test? It is advisable to start getting a Pap Smear test at least every three years, from the age of 21 onwards till you reach 65. For optimally accurate results, wait for at least 5 days after your menstrual period to get the test done.

HPV Screening Test

A Pap Smear Test can be combined with the HPV screening test, specifically to check for presence of cancers arising from the human papillomavirus. Done by taking a swab sample, the HPV test specifically ascertains whether or not there is a presence of HPV in your cervix. For optimally accurate results, it is best to avoid sexual intercourse, as well as, application of vaginal jellies etc. for at least two days before the test. Also wait for your menstrual cycle to get over before you do the test.

If the Pap Smear and/HPV tests yield positive or inconclusive results, then, the doctor might recommend a colposcopy or biopsy to be done to get proper conclusive results. That is because, Pap and HPV tests can only show whether there’s a presence of abnormal cells in the cervix. They cannot prove for certain, whether the woman has Cervical Cancer or not.

What should you ask your gynaecologist?

Do not be afraid if your colposcopy or biopsy results shows the presence of Cervical Cancer. Remember, this cancer is curable if detected well in time.

To aid effective management of the disease, ask the doctor to explain the diagnosis and lab test reports to you in layman terms. Also ask, up to what stage has your cancer progressed, has it spread beyond the cervix, and what are the various treatment options available to you at that stage.

It also helps to get clarity about what exactly the treatment will entail, how long will the treatment go on for, and if it will cause any side-effects. Also clarify what are the chances that you may get afflicted by Cervical Cancer again in the future, after the treatment is completed?

The HPV vaccine – Should you take it?

A preventive measure to avoid Cervical Cancer, as well as a host of other problems like genital warts, vulvar cancer, vaginal cancer etc. that are caused by human papillomaviruses transmitted via sexual contact, is to take the HPV vaccine.

HPV is a group of almost 200 viruses, out of which 40 are spread via sexual contact. Some of these, like HPV 6 and HPV 11, are low-risk HPVs that lead to non-cancerous problems like genital warts and respiratory papillomatosis. However, HPV 16 and HPV 18 are known to be high-risk variants that lead to almost 70% of pre-cancerous cervical lesions, and Cervical Cancer.

The WHO recommends certain vaccines to protect the user against infections arising from HPV 16 and HPV 18. For optimum results, these vaccines are best given between the ages of 9 to 26, in specified doses.

The vaccines help the body produce antibodies that bind to the virus and disallow it from infecting cells. However, this vaccine cannot prevent other sexually transmitted diseases. They are also ineffective against existing HPV infections or diseases.

Summary

Remember, when it comes to cervical cancer, screening is critical. This is because in the early stages of cancer, when there are no signs of the disease, is when the cancer is most treatable. All these tests are simple, easy to get done at a doctor’s clinic, and not too painful. So, women should not feel afraid or shy to get the tests done in proper time.

Remember, prevention is always better than cure. Inhibitions and fear will only lead to an increase in your problems. Cervical Cancer can be arrested and cured before it becomes dangerous.

So, take charge of your health, go for routine check-ups, and take screening tests to keep yourself free from Cervical Cancer.

After all it takes only #10minutestochange.

To know more on Cervical Cancer, engage with our Say No To Cervical Cancer Campaign.

References:

https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/cxca/cxca-profiles/cxca-profiles-en.pdf?sfvrsn=d65f786_13

https://gco.iarc.fr/today/data/factsheets/populations/920-south-eastern-asia-fact-sheets.pdf

https://www.cancer.net/cancer-types/cervical-cancer/symptoms-and-signs

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/preventing-cervical-cancer-is-now-possible/articleshow/80649079.cms

https://hpvcentre.net/statistics/reports/LKA_FS.pdf

https://hpvcentre.net/statistics/reports/MYS_FS.pdf

https://connect.uclahealth.org/2021/02/18/understanding-the-link-between-birth-control-pills-and-cancer-risk/

https://www.webmd.com/women/guide/pap-smear

https://www.nature.com/articles/s41416-020-0831-9

https://www.informaticsjournals.com/index.php/ajprhc/article/view/25208

https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/talking-with-your-doctor.html

https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet#:~:text=In%20addition%2C%20oral%20contraceptives%20might,of%20virtually%20all%20cervical%20cancers

https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer

https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet