We are all aware that cancer is a disease in which cells in certain body parts grow out of control. In cervical cancer, cells in the cervix grow out of control. It is the fourth most common form of cancer in women. Before we get to know more about cervical cancer, let us know what this cervix is. Where is it located in your body? And finally what does it do?
Cervix is the gateway between the uterus and vagina. It protects the uterus and its sterile environment from the external world. It is more like a tubular structure about 1-2 inches in length. The cervical opening is called as os -the uterus end is called internal os and vaginal end is called external os.
Owing to its elastic nature it can vary in length and width during a woman’s menstrual cycle. Throughout the cycle both internal and external os will not only open and close but also it will move higher or lower depending on the phases of the cycle. In addition to this secretions of the cervix also alter being thin or thick mucus making vagina more acidic or alkaline.
Os in pregnancy will be lower and tightly closed throughout the pregnancy. In fact the major role of the cervix is to maintain the fetus inside the uterus as pregnancy progresses and the fetus moves more downwards towards vagina. However, as the term of pregnancy is completed and it is time for labour to start, it will open and dilate to allow passage to the baby to come out of the uterus. During ovulation it will be higher and open to allow entry of sperms for conception; also secretions are more thin and alkaline to favour sperm survival and movement.
Causes of cervical cancer
Almost all cases of cervical cancer are linked to HPV (Human Papillomavirus) infection. This virus is mostly spread during sexual contact. Though HPV infection can resolve without any symptoms, persistent infection can lead to cervical cancer. You are at higher risk of developing cancer if
- Sex at early age
- Multiple sexual partners
- Persistent infection of cervix with HPV
- Giving birth to many children
- Prolonged use of birth control pills
- Weak immune system
- Other STDs
Incidence in India
27% of the total cervical cancer cases globally are from India. More women die in India of cervical cancer than in any other country. Almost 1 lakh new cases are reported every year and nearly 60,000 deaths in a year due to cervical cancer. However, with the introduction of national awareness and screening programmes, conducted by the Government of India and various pharmaceutical companies, this rate is declining .
Screening and treatment
Cervical cancer is preventable because it has a well defined and relatively long pre-cancer stage which can be detected by regular screening tests and follow up. However, most women in India are not aware about the screening.
Cervical cancer is detected with the help of a technique known as PAP test. It is a test in which a small sample is collected from the cervix to observe for any abnormality or infection in the cells. This also helps diagnose any lower reproductive tract infections. If any abnormality is found, further biopsy and tests are performed to confirm the cancer. As per international guidelines any women between ages 21-65 should get this screening test done every 3 years.
When you should consult your doctor
- Abnormal vaginal bleeding: unusually long and heavy period, bleeding after menopause
- Excessive vaginal discharge with foul smell
- Painful intercourse
- Bleeding after intercourse
- Persistent pain in lower abdomen or pelvic area
Presence of one or more of these symptoms does not imply that you have cancer. However, it is advisable to seek medical attention before the problems worsen.
Cervical cancer is one of the few forms of cancers which can be effectively treated and managed if diagnosed early and managed appropriately. You can prevent your chances of getting infection with HPV with use of condoms and adapting safe sexual practices. There are vaccines available for prevention of HPV infection. The recommended age for initiation of vaccination is 9–14 years and follow up doses are taken as per regime.
The Indian Academy of Paediatrics Committee on Immunisation (IAPCOI) recommends offering HPV vaccine to all females who can afford the vaccine. Currently, there are two vaccines available in India, both are safe and efficacious. Both of these are approved by the Drug Controller General of India (DCGI), US Food and Drug Administration, European Medicines Agency and prequalified by the World Health Organisation. However, vaccination does not guarantee complete protections against cervical cancer and routine check-up and screening are still recommended.