Cervical cancer is cancer of the cervix — the lower part of the uterus, which opens into the vagina. Cervical cancer is the second-most-common type of cancer that strikes women worldwide after breast cancer.
It is estimated that nearly 250,000 deaths are associated with cervical cancer globally every year. According to the World Health Organisation, there were 500,000 new cases of cervical cancer in 2005.
The tragedy of cervical cancer is that it often strikes when a woman is still young. It tends to happen in women between the age of 35 and 55 years. She may be trying to raise her family or may be she has not had children yet.
A population-based survey reported that the coverage of cervical cancer screening in Bangladesh is less than 1%. Older and poor women are at the highest risk of developing cervical cancer in Bangladesh.
Cause of cervical cancer
99% of cervical cancers are caused by Human Papillomavirus (HPV), which spreads through sexual contact. There are over 100 different types of HPV. The majorities of viruses are considered Low Risk and do not cause cervical cancer. However, HPV-16 and HPV-18 often referred to as High Risk HPV types are associated with more than 70% of cervical cancer cases.
The body’s immune system usually fights off the infection as a result most women never suffer from HPV infection. However, in some women the infection does not go away. When the virus remains active in the body for a long period of time, cervical cells begin to change and the risk of cervical cancer increases.
There are other factors can increase the risk that an HPV infection develops into cervical cancer:
* Sexual intercourse at an early age
* Multiple sexual partners
* Multiple full-term pregnancies
* Chlamydia, gonorrhoea, syphilis, or herpes simplex virus type 2 infection
* Cigarette smoking
* Use of oral contraceptives for a long period of time
* Weakened immune system or HIV infection • Mother or sister with a history of cervical cancer
* Low levels of folic acid (a type of Vitamin B)
Cervical cancer is usually a slow-growing cancer, typically takes 10-15 years before invasive cancer develops. Once cervical cells begin to change, it first becomes “pre-cancerous” a condition also known as “dysplasia” or Cervical Intraepithelial Neoplasia (CIN).
In the early stages cervical cancer often causes no symptoms. However, when symptoms do occur, they may include:
* Bleeding between regular menstrual periods
* Bleeding after sexual intercourse
* Bleeding after douching
* Bleeding after a pelvic exam
* Pelvic pain not related to your menstrual cycle
* Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
* Increased urinary frequency
* Pain during urination
These symptoms can be caused by cervical cancer, or by a number of serious conditions, and should be evaluated promptly by a medical professional.
Cervical cancer is diagnosed through a series of examinations. A Pap test is most commonly used to screen and detect the possibility of a cervical cancer or dysplasia.
An HPV DNA test is used to determine the high-risk strains of HPV infection, which is most likely to lead to cervical cancer. If an abnormality is found during a Pap and HPV DNA tests, a Colposcopy is performed.
Finally, a Cone biopsy is performed by removing a cone-shaped piece of tissue from the cervix for microscopic examination. A pathologist examines the sample for confirmation of precancer or cancer cells.
Options for treating cervical cancer depend predominantly on the stage of disease — the size of the tumor, the depth of invasion, and whether the cancer has spread to other parts of the body.
Other factors that are considered are the patient’s age and if she wishes to have children. The primary forms of treatment are surgery or combined radiation therapy and chemotherapy.
* Surgery to remove the uterus
* Radiation therapy to kill the cancer cells
* Chemotherapy to stop the growth of cancer cells
The vaccine is now available for prevention of HPV infection. Studies show that women who receive cervical cancer vaccine between the ages of 15 and 25 have 100% protection against the HPV-16 and HPV-18.
The vaccine is given in three shots over six-months. Centers for Disease Control and Prevention (CDC) recommended this vaccine for girl’s ages 11 to 12, although it may be used in girls as young as age 9.
Ideally, females should get the vaccine before they are sexually active. The vaccine is also recommended for 13-26 year-old girls who have not yet received or completed the vaccine series. This allows a girls immune system to be activated before she encounters HPV. Vaccinating at this age also allows developing the highest antibody levels. The higher the antibody levels the greater the protection.
Abu Siddiqui, Ph.D., is an immunologist working in a multinational health care company in the United States of America.
Source: The Daily Star, January 10, 2008