Cervical cancer can be prevented by regular screening tests
Cervical cancer is the second most common cancer in women worldwide and the second leading cause of cancer in women in the UAE. It develops gradually, hence it is one of the most preventable types of cancer. It affects commonly in midlife, half of the women being 35 – 65 years of age.
Cervical cancer can be considered as a sexually transmitted disease as Human Papilloma Virus (HPV) is a sexually transmitted virus, which is found in 99 per cent of all cervical cancers. There are more than 100 types of HPV, most of which are low risk, and around 15 types which cause cervical cancer. There are high-risk types which cause pre-cancer and cancer of the cervix. More than 70 per cent of the cervical cancers are associated with high-risk types of HPV — Type 16 and Type 18.
The natural course of HPV infection will clear itself within two years. In a small percentage of women, persistence of infection with high risk virus can lead to cancer of the cervix.
The transition of changes in the cervix from pre-cancerous to cancer can take up to 20 years. Low risk HPV types cause genital warts, high risk HPV can also predispose to cancer of genitalia, anus and throat, in men and women. Cervical cancer can be prevented by regular screening tests called ‘Pap smear’. Other preventive measures include HPV vaccine and observing safe sex practices.
The risk factors for HPV infection include early age of sexual exposure, multiple partners, smoking, using oral contraceptives, giving birth at a very young age and having other sexually transmitted infections.
Pap smear is a screening test which looks for changes in cells of the neck of the womb, which if untreated, can progress to cancer of the cervix.
The Pap test can detect changes in the cells (pre-cancer) before it changes to actual cancer. Pap testing should be started within three years of sexual exposure or from age of 21 to 65 years, whichever is the earlier, and frequency of testing is once in three years.
HPV vaccine can protect against infection by HPV types that most commonly cause cervical cancer, and HPV types which cause genital warts. HPV vaccine can reduce chance of cervical cancer by 70 per cent.
It is less effective in preventing HPV related disease in women already exposed to HPV, does not treat infection or disease caused by HPV. Recommended age of vaccine for girls is from ages 13–26 years and for boys from age 9–26 years.
Three doses of the vaccine are recommended to be given over six months. Below age 15 years, only two doses of the vaccine are required at six month intervals. Even after vaccination, cervical cancer screening should continue after age 21 years, as the vaccine does not protect against all types of HPV infection.
Symptoms of cancer cervix include irregular bleeding between periods, bleeding after sexual contact, excessive foul smelling discharge and bleeding after menopause.
In the UAE, HPV vaccine is given free to all girls 15-17 years in Abu Dhabi. It is part of the national immunisation programme in over 64 countries. Dr Josephine Jose is a consultant in Obstetrics / Gynecology at International Modern Hospital (This article is sponsored by the advertiser.)