Cervical cancer is cancer in the tissues of the cervix, the organ that connects the uterus with the vagina, and is a major cause of cancer mortality among women, with over a quarter of the burden borne by developing nations like India. Almost all cases of cervical cancer are caused by the human papillomavirus or HPV.

The good news is cervical cancer can very often be prevented through periodic screenings like Pap and HPV tests to detect the disease at a pre-cancerous stage and treat it effectively. If detected at an early stage, chances of a complete cure are a staggering 85%. The HPV vaccine can also help prevent cervical cancer. Nearly 93% of cervical cancers could be prevented through screening and vaccination.

Hence, the criticality of screening can hardly be overemphasized. Regular screening can help detect abnormal cervical cell changes and treat the condition before it develops into full-blown cervical cancer, thus potentially saving so many lives. In India, surprisingly, in spite of the high incidence, there isn’t any centrally mandated national screening programme. All the more reason to be on your guard and go for regular screening proactively…

There are two types of cervical cancers: one is Squamous cell cervical cancer or cancer on the outer surface of the ectocervix, which projects into the vagina, and the other one is adenocarcinoma of the cervix or cancer of the endocervix, the inner region of the cervix.

What are the cervical cancer screening procedures?

• HPV test: Sample cells harvested from the cervix are tested for strains of HPV, the most common cause of cervical cancer. The test can also be performed on sample cells self-collected from the vagina. HPV tests are either done in isolation or in tandem with Pap tests.
• Pap test: The Pap test or Pap smear is the most common screening tool used to detect early cell changes that could develop into cervical cancer. A Pap test is performed on sample cells collected from the cervix and is often part of a routine gynaecological workup or a pelvic examination.
• Clinical examination with acetic acid: In this simple method, the doctor applies a dilution of white vinegar on the cervix to look for any red flags or unusual markers.

Are there any known risk factors for cervical cancer?

HPV, mostly sexually transmitted, is the main cause of cervical cancer, with HPV-16 and HPV-18 accounting for almost 70% of cases worldwide. Some other known factors include:

• Family history of cervical cancer
• Compromised immune system
• History of smoking
• Uncontrolled and prolonged stress
• Contraceptive pills might also raise the risk
• HIV infection
• Obesity
• Multiple full-term pregnancies

What are the early warning signs of cervical cancer?

Most often, there are no symptoms at all. Still, watch out for and see a doctorif you experience any of the following:

• Abnormal vaginal bleeding
• Unusual, continuous vaginal discharge
• Pain during sexual intercourse or in the pelvic region

The problem is that the cervical cancer disease is often asymptomatic till it becomes full-blown and invasive, when one experiences symptoms like unusual bleeding after sexual intercourse, post-menopause or in between periods. Many women are prone to miss or dismiss the early warning signs, which can prove really costly, even fatal. Hence, it’s absolutely vital to go for periodic screenings so that the disease can be detected at a pre-cancerous stage and treated to achieve total cure. In this light, efforts to increase awareness about the different screening tools for cervical cancer including Pap smear and HPV test must be increased. In resource-poor countries like India, at least visual screening should be promoted and integrated into the primary healthcare programme.