Cervical cancer is the cancer affecting the lower part of a women’s womb which is called Cervix. When the healthy cervical cells develop changes in their DNA, they become cancerous cells. There are two types of cervical cancers – one is squamous cell which begins on the outer surface of cervix. The other is Adenomatous cancers which begin in cells lining the cervical canal.
As per findings, globally cervical cancer is the fourth commonest cancer found amongst women. In 2022, 660 thousand new cases were found and it resulted in 350 thousand deaths. In India, the incidence is about 22 per lakh women and mortality is 12.4per lakh women per year.
Dr Monika Jani, Gynaecologist and Obstetrician at Bhailal Amin General Hospital, Vadodara, explains, “The signs and symptoms of the disease are post coital bleeding or bleeding in between periods or after menopause. People with a cancerous cervix may have heavier periods, thin watery or blood stained discharge which may be foul smelling. Some women also experience pelvic or abdominal pain. HPV virus is implicated in causing cervical cancer. An HPV infection is transmitted by sexual contact. Upon exposure to the infection, the immune system tries to clear the infection. However, in some cases virus survives for years and contributes to changes that cause cancer.”
Risk factors to cervical cancer include smoking, multiple sexual partners, sexual activity at an early age, weakened immune system, having other sexually transmitted diseases, and exposure to drugs like DES. However DES is not used now. “Sexual activity at an early age and multiple partners increase chances of exposure to HPV and thus higher chances of getting the disease,” adds Dr Jani.
How smoking causes cervical cancer is not exactly known but it is believed that smoking causes persistence of HPV and so the cancer. “Usage of oral contraceptives have shown to increase the risk of cervical cancer. Longer the use, more the chances of getting cervical cancer. Discontinuing the use decreases the incidence of the cancer. Oral contraceptives are believed to make cervical cells more susceptible to high risk HOV viral strain,” explains Dr Jani.
Protection from HPV infection by taking the vaccine available decreases the chances of cervical cancer significantly. “Safe sexual practices also decrease the risk. It is also important to follow the guidelines of screening programmes. All sexually active women in their twenties should get a PAP smear every three yearly and after that every five yearlies along with testing for HPV. Failure to do adequate screening prevents early diagnosis of various precancerous and early stage cancer. This significantly increases the morbidity and mortality due to cervical cancer,” shares Dr Jani.
Cultural differences between urban and rural population may show a different aetiology to the disease like say in urban population smoking or higher use of contraceptives may be a risk factor and in rural population it may be early sexual initiation due to early marriages.
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