Business Standard

Bolstering the fight against cervical cancer

- HARSHA KHULLAR Senior Consultant, Obstetrics & Gynaecolog­y, Sir Ganga Ram Hospital, New Delhi

Consider the following facts: 67,000 women die every year in India due to a rather preventabl­e disease, namely — cervical cancer, and more than 1.2 lakh women are diagnosed with it. The ever-increasing burden of non-communicab­le diseases (NCDs) in the country is a cause of great concern and cervical cancer is a vital component of NCDs - also the leading cause of cancer among Indian women. The burden of cervical cancer has only spiralled over the years in our country with the increased incidences of human papilloma virus (HPV) infection and with inappropri­ate lifestyle choices. In India, cervical cancer contribute­s to approximat­ely 6-29 per cent of all cancers in women and our country is home to 25 per cent of all cervical cancer deaths in the world. The only way we can combat this is by undergoing regular screenings for detection and proper treatment of cervical cancer.

What causes it

Cervical cancer surfaces from the cervix and is primarily caused by HPV, which most commonly is contracted after sexual contact. Vaginal bleeding, off and on, post coital bleeding are some of its prominent symptoms. Neverthele­ss, it falls under vaccine-preventabl­e diseases, which makes periodic screenings an indispensa­ble part for its prevention and detection. Detection

Decreasing the incidences of cervical cancer is not solely restricted to screenings after the symptoms have developed. Screenings by Pap smear is instrument­al to identify cancer at an early stage, before the occurrence of symptoms. Once in a life time screening for cervical cancer can reduce the chance for developing cancer in 25 per cent cases; screening every three years can reduce the risk of cervical cancer by 70 per cent. Moreover, they are invaluable in finding abnormal cells in the cervix and performing further tests like colposcopy and biopsy to help prevent cancer from advancing.

Federation of Obstetric and Gynaecolog­ical Societies (FOGSI) has laid certain guidelines for screening. The American Cancer Society states that all women should begin screenings for cervical cancer at the age of 21, and between the age of 21 and 29 if they are sexually active, or two years after initiating sexual life, and do it every three years.

Pap Smear is an old technique and has been the go-to technique for cervical cancer screenings for quite some time now. Although it has been proven to be beneficial, several studies during the past decade have pointed out that the Liquid Based Cytology (LBC) has increased the detection rate than Pap Smear, and can save patients further visits to the hospital in case cytology is abnormal as the HPV test can be done by using same collection vial.

If cervical cancer is detected at precancero­us or nascent stage, the chances of survival dramatical­ly increase to more than 85 per cent. Developing and implementi­ng the best screening techniques will traverse a long way to ensure the proper detection and early treatment of cervical cancer.

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