Cervical cancer or cancer of the cervix, the lowermost part of the uterus, is the most common form of cancer in Indian women, especially rural women. Despite this, the awareness about it is very low. Being a gynaecologist, I come across several such cases regularly.
Last year, a 28-year-old woman was wheeled into the emergency with an advanced stage of cancer cervix. Her condition was critical. The regret in the teary eyes of her husband that they chose to consult a local doctor and a not a cancer hospital, made me write this.
In cervical cancer, the pre-cancerous changes start after the woman is sexually active, usually in her twenties. If undetected, it may turn into a full-blown cancer by the time she reaches her 50s. Cervical cancer is spread by the Human Papilloma Virus (HPV) and is transmitted sexually. While this cancer is preventable, condoms are not fool-proof protection as the area which is not covered by the condom may be infected and can lead to the transfer of the virus.
A very good and inexpensive screening test called the PAP smear test can identify it several years ahead at a pre-cancerous stage, which can help prevention and early treatment. An effective vaccine is also available to prevent the disease.
Sexually transmitted infections are a rising concern and have long-term consequences. Multiple sex partners, early initiation of sexual activity, poor knowledge of contraception, hesitation in using the barrier method by male partners, low socio-economic status with poor access to health care services are some of the high risk factors that lead to this disease.
Prostitutes, prison inmates, drug addicts and those undergoing treatment for a sexually transmitted disease are in the risk category. Other factors that can lead to cervical cancer are smoking, low immunity status like HIV, use of birth control pills for more than 5 years, being younger than 17 at the time of the first delivery and having three or more children.
Cases of cervical cancer continue to rise, especially in the developing nations. Most of those who suffer from it do not turn up in the hospitals or undergo the PAP smear test in time. This includes educated women and even doctors.
According to a report published by the Centers for Disease Control and Prevention, young people aged 15-24 years develop half of all new sexually transmitted infections (STIs) and one in four sexually active adolescent girls have a sexually transmitted infection.
This could perhaps be the reason that the age limit for administering HPV vaccine has been lowered; it works best if given before a girl becomes sexually active and gets infected with the virus. The report also observed that one-quarter of adolescents and young adults in high-risk age groups for sexually transmitted infections did not have healthcare coverage. It noted that almost two-thirds of women between 18-60 years of age who were surveyed, knew nothing or very little about such infections other than AIDS.
Young women and adolescent girls are more susceptible to sexually transmitted infections compared to their male counterparts because of their biological characteristics. In many cases, men refrain from using condoms. Women and adolescent girls find it difficult to impose protective behaviour.
The government must promote the cervical cancer vaccine and make it cost-effective and free for all adolescent girls. Some of the ways to keep cervical cancer in check are encouraging the use of contraception, enforcing PAP Smear tests in sexually active women at least every 3 years or combining it with an HPV testing every 5 years.
The most effective way of curbing the rising epidemic is by inculcating responsible behaviour. It may sound like a cliché, but if you don’t take a detailed sexual history of your partner on a date, you don’t know him well enough to have sex. And safe sex is sex with your faithful spouse.
– Tripti Sharan is a practicing gynaecologist from New Delhi and a writer in her moments of introspection. Her recent book ‘Chronicles Of A Gynaecologist’ is inspired from real life experiences.
– Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.