Cervical cancer is the second most common cancer among women globally, following breast cancer, and continues to be a major cause of illness and death. However, it is largely preventable through early detection and increased awareness. To highlight the importance of prevention and early screening, the World Health Organization (WHO) observes “Cervical Cancer Awareness Month” every January.

Understanding Cervical Cancer and Its Prevention

Cervical cancer develops due to an infection caused by the Human Papillomavirus (HPV), which affects the cervix – the mouth of the uterus. HPV infection can lead to ulcers or sores on the cervix, which may gradually develop into cancer throughout 10 to 15 years. This prolonged latent period offers a unique opportunity for prevention. If detected early, during the pre-cancerous stage, cervical cancer can be successfully treated before it progresses to a full-blown cancerous state.

The Importance of Screening

Regular screening is crucial to prevent cervical cancer, and the primary screening method is the PAP smear test. This non-invasive test, which requires no anesthesia, involves collecting cells from the cervix to detect any abnormalities. The test can identify changes in the cervix that may lead to cancer, which cannot be detected through ultrasonography or CT scans. Women should undergo this test every three years, starting at the age of 21 or once they become sexually active.

If any abnormality is detected during the PAP smear, further investigations such as a biopsy are performed to confirm the diagnosis. Early diagnosis and timely treatment significantly reduce the risk of progression to cancer.

Symptoms and Risk Factors

While cervical cancer may not show symptoms in its early stages, some signs may indicate the presence of the disease:

• Abnormal white discharge
• Bleeding between periods (intermenstrual bleeding)
• Bleeding after intercourse

Women experiencing any of these symptoms should immediately consult a healthcare provider and get a PAP smear test done.

Several risk factors can increase the likelihood of developing cervical cancer, including:

• Smoking
• Multiple sexual partners
• Long-term diabetes
• Use of long-term steroids, which can weaken the immune system

The Role of Vaccination

There is a vaccine available to prevent HPV infection, which in turn helps to reduce the risk of cervical cancer by up to 90-95%. The vaccine is most effective when administered between the ages of 9 and 14. Many countries, including India, have now made this vaccine available to girls and boys. The vaccine can still be given to women over 40 years of age or those who have already had children, although its effectiveness may be slightly reduced after this age.

Treatment of Cervical Cancer

If a PAPsmear reveals abnormalities, a biopsy is conducted for a definitive diagnosis. If the biopsy confirms the presence of cancer, MRI scans are used to determine the stage of the disease. If cervical cancer is detected at an early stage (Stage 1), surgery is typically performed to remove the cancer. In cases where the cancer has spread beyond the uterus, treatment options include chemotherapy and radiation.

Robotic surgery, a minimally invasive technique, is increasingly being used for cervical cancer treatment due to its quicker recovery time and reduced risk of complications. When diagnosed at an early stage, the survival rate for cervical cancer is high with 90 out of 100 patients making a full recovery. Modern treatment approaches can cure up to 30% of patients even at Stage 4.

Effective cervical cancer treatment requires a holistic approach, with all services like biopsy, surgery, chemotherapy, and radiation therapy made available under one roof. Early detection through regular PAP smear screenings is key to prevention, while advancements in treatment, including robotic surgery, offer hope for better outcomes. With timely screenings, vaccination, and comprehensive care, we can significantly reduce the risk and improve survival rates for cervical cancer patients.

About the author- Dr. Kaustav Basu, Clinical Lead and Senior Consultant – Gynaecology-Oncology and Robotic Surgery, Narayana Hospital, Howrah.

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