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Cervical Cancer and its Prevention

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08 November 2011

•

1 minute read

Cervical Cancer and its Prevention

By Dr. Rama Krishna Kumar Krishnamurthy

What is cervical cancer?

The cervix is the lower part of your uterus (womb). The cancer of this part of uterus is called cervical cancer. Cancer of the cervix (cervical cancer) is a serious but preventable disease. It is the third most common cancer among Malaysian Women.

What causes cervical cancer?

Since most of the all cervical cancers are caused by Human Papilloma Virus (HPV), any woman who has sex can get cervical cancer. Most women who’ve had sex have been exposed to HPV at some time in their life. Usually, your body’s immune system fights off the infection, and HPV goes away on its own. The women at highest risk for cervical cancer are women in whom infection with one of the high-risk types persists for years. Other risk factors for cervical cancer include smoking, multiple sexual partners and HIV infection.

HPV infection and how is it related with Cervical cancer?

HPV is a family of very common viruses that can cause cervical cancers, plus a variety of other problems like common warts, genital warts and plantar warts. HPV also causes cancers of the vulva, vagina, anus, and cancers of the head and neck. Women and men become infected with HPV types that cause cervical cancer through skin to skin especially during sexual contact and sexual inter course not necessarily has to happen. Most women will be exposed to HPV during their lifetime.

The most common cancer-causing types of the virus are 16 and 18. This is important to know because these two types alone cause about 70% of all cervical cancer. The cervical cancer vaccine protects against these two types 100% of the time.

An HPV infection rarely leads to cervical cancer. In most women, the cells in the cervix return to normal after the body’s immune system destroys the HPV infection. However, in some women, the HPV infection remains and causes changes in the body’s cells. If these abnormal cells are not found and treated, they may become cancer. Normally this progress can take from 10-20 years.

Do I have HPV infection?

In most cases, you won’t have any symptoms of an HPV infection. The only way to know if you have an HPV infection is to have a direct test for the virus which is performed right from the Pap test container or by using an additional swab at the time of the Pap test. The only way to tell if a high-risk HPV infection has caused the cells in your cervix to change is to have a Pap test. Signs of an HPV infection may appear weeks, months or years after the first infection, which is why it is important to have regular tests.

How to treat HPV?

Currently, there is no treatment for the virus. There are treatments for the cervical changes that HPV can cause. If your Pap and HPV tests show that cells in your cervix have changed, you should discuss treatment options with your doctor.

Girls and women age 9-45 can protect themselves from HPV and cervical changes related to HPV by getting the cervical cancer vaccine. There are two types of vaccines in the market. One is quadrivalent vaccine which consist of HPV strains of 16, 18, 11 & 6, this vaccine protects against the most common HPV that cause cervical cancer, genital warts and recent studies shows that it has protection against ano-genital cancers. The other vaccine is a bivalent vaccine with HPV strains of 16 & 18 which protects against cervical cancer. The quadrivalent is called Gardasil and is recommended from the age 9-26 years. The bivalent vaccine is called Cervarix and is recommended from the age 9-45 years.

What is a Pap test?

Screening tests can find changes in cervical cells before cancer develops. Changes in cervical cells before cancer develops are called dysplasia. Removing cells that have dysplasia can prevent cervical cancer. If left untreated, dysplasia can lead to cervical cancer. Screening tests can help prevent cervical cancer. Cervical cancer can be cured if it’s found at an early stage.

What should I do before a Pap test?

Don’t take the tests if you’re having your menstrual period.

Don’t douche for 2 days before the tests.

Don’t have sexual intercourse for 2 days before the test.

Don’t use tampons or birth control foams, jellies, or other vaginal creams or vaginal medicines for 2 days before the test.

When I should commence Pap test and till how long?

After 3 years of commencement of sexual activity every 1 or 2 years once and 3 yearly if 3 subsequent Pap test are normal. Once menopause you can do every 3 yearly and stop once 3 subsequent Pap test are normal with negative HPV DNA test.

What is the difference between Pap test and HPV vaccination?

These are two different prevention methods advocated for cervical cancer. HPV vaccination is called primary prevention whereby we are eliminating the most common risk factor that is HPV infection. So when there is no HPV infection then there are no cervical cell changes.

Pap test is to detect cervical cell changes at earliest stage as possible and do the necessary treatment. This is called secondary prevention.

However taking HPV vaccination does not give 100% protection against cervical cancer. We still recommend continuing Pap test at least biannually.

Conclusion and take away message

The single most important thing that a woman can do is to participate in a regular screening program. All women who are screened experience a dramatic reduction in the risk of cervical cancer compared to women who do not get tested. Make you appointment today!

Most cervical cancer is preventable. Early vaccination plus detection of abnormal cell changes with a Pap test are important. Cervical cancer is rare, and almost always prevented through regular screening and treatment of pre-cancerous changes.

At least 75% of women will have HPV at some point, but very few will develop cervical cancer. Most HPV infections are temporary and will go away on their own. An HPV infection that does not go away over a period of years might lead to cervical cancer.

The new screening options including liquid-based Pap tests and the test for high-risk HPV are important developments for women and their physicians. The HPV vaccine will prevent many Pap test abnormalities and most cervical cancer.

If you are a girl or woman between 9-45 years of age, you should be vaccinated against HPV. Remember, just because you have had the vaccine does not mean you should stop having Pap tests. Early vaccination and regular screening provides your best protection against cervical cancer.

Reference:

  1. Cancer Institute, www.cancer.gov
  2. Saslow D,Castle PE et al ;American Cancer Society Guideline for Human Papillomavirus (HPV) Vaccine Use to Prevent Cervical Cancer and Its Precursors :CA Cancer J Clin 2007; 57:7-28 doi: 10.3322/canjclin.57.1.7 © 2007 American Cancer Society
  3. Centers for Disease Control and Prevention (CDC);http://www.cdc.gov/cancer/cervical/

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08 November 2011

•

1 minute read

Cervical Cancer and its Prevention

By Dr. Rama Krishna Kumar Krishnamurthy

Dr. Rama Krishna Kumar Krishnamurthy

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