Cervical Cancer: Why women need to be vaccinated

by Dr. Rohit Kumar C, Consultant - Surgical Oncology & Robotic Surgery, HIPEC & PIPAC Specialist, Aster CMI Hospital, Bangalore

Cervical cancer is one of the most aggressive forms of cancer among women. Every year January is observed as Cervical cancer awareness month to raise knowledge about the disease's signs, symptoms and preventive measures and call to action to increase efforts to curb its incidences.

Even though cervical cancer is curable, it remains the fourth most common cancer in women worldwide, with India contributing to one-fourth of these cases.

What are the factors that cause cervical cancer among women?

The Human Papilloma Virus (HPV) is the most common factor that causes cervical cancer among women. This virus usually takes 15-20 years from the contraction stage to cancer development. Individuals diagnosed with cervical cancer develop a precancerous condition called dysplasia which, when left untreated, leads to cancer. 

Most women contract this virus during their reproductive age with or without any symptoms.  Most HPV infections clear without any interventions within two years. Only when the virus integrates with the cells, it progresses to cervical cancer, making regular screening and vaccination essential for women.

What are the signs and symptoms of cervical cancer?

Common signs and symptoms of the disease include -

●       Abnormal bleeding - If you are experiencing excessive bleeding after intercourse, during the menstrual cycle and in-between periods, you must seek immediate attention and evaluation.

●       Postmenopausal bleeding - If vaginal bleeding occurs more than a year after your last period, you must undergo a complete evaluation of your uterus and cervix to rule out the emergence of cervical cancer.

●       Foul-smelling vaginal discharge - While this is a sign of vaginal infection, however, vaginal discharge emitting a foul odour could also be a sign of cervical cancer.

●       Severe strain in lower-back strain - This often occurs in advanced stages of cervical cancer.

How early screening and HPV vaccination can prevent you from cervical cancer?

It is widely recommended that women between the ages of 21-65 should undergo regular pap smears once every three years. In case you have been screened with the HPV DNA along with a pap smear (Dual testing) after 25 years of age, then this screening interval can be increased to 5 years. 

Currently, the most effective way to reduce the incidence of cervical cancer is HPV vaccination. These vaccines are administered to girls between the ages of 9-14 and have proven effective in reducing the incidence of precancerous lesions and cancer. Additionally, teenagers and women aged 15-45 who have not received these vaccines during their childhood can take HPV vaccines only after discussion with their physician, because its effectivity in them is not like in young teenagers. The usual dosage for young girls is two doses at an interval of 6 months and for teenagers and women is three doses.

It is important to consult your physician before taking the HPV vaccine. The HPV virus can also cause other types of cancers, such as anal cancer, vulval cancer, vaginal cancer & head and neck cancer; therefore, all young women should get vaccinated. 

Lastly, following safe sexual practices can help reduce the risk of developing an HPV infection and thus cancer.

The World Health Assembly adopted the global strategy to accelerate the elimination of cervical cancer as a public health problem. The definition of elimination of cervical cancer has been set up as a country reaching the threshold of less than 4 cases of cervical cancer per 100 000 women per year. To reach this threshold by the end of 21st century, WHO has set up the 90-70-90 targets to be reached by 2030 and to be maintained.

90% of girls fully vaccinated with HPV vaccine by age 15;70% of women are screened with a high-performance test by 35, and again by 45 years of age; and 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed).