Cervical cancer is the leading cause of cancer deaths in women, accounting for about 23 per cent because of the late detection of the disease. In general, women over the age of 30 who have a chronic human papillomavirus (HPV) infection are at higher risk of developing cervical cancer. Its symptoms are usually much less minor in the form of vaginal bleeding or discharge. But about 80 percent of cervical cancer cases can be prevented by adopting proper methods of prevention. Cervical cancer prevention is 99 percent effective with HPV vaccination and screening alone.
How To Prevent Cervical Cancer
Primary prevention
(Most effective for girls 9–15 years old) is the HPV vaccine, which can be given to women between the ages of 9–45 years, but girls under 15 years of age tend to have stronger immune systems. For complete protection, two doses are recommended for girls under 15 years of age and three doses for women between 15-26 years of age. Women over the age of 27 should consult a doctor before getting the vaccine. Gardasil 9 (the FDA-approved vaccine in the US) is nearly 100 percent effective in preventing cancer caused by HPV types (6, 11, 16, 18, 31, 33, 45, 52, and 58). As far as awareness is concerned, education should be provided to young girls and boys according to their age and environment.
Secondary Prevention
(Which is effective for women over the age of 30) involves screening and treating precancerous lesions. There are a number of tests that have been shown to be effective in reducing the risk of developing the disease, including cytology (Pap smear), co-testing (HPV−cytology), primary HPV testing, and visual inspection with acetic acid. And at present they are used in various situations. Cytology is the most commonly used test, which can be done every 3 years or 5 years, along with HPV testing in women between the ages of 30 and 65. Screening of women suffering from HIV infection should be started soon. It is a very cost-effective method of cancer prevention, as it can treat early changes of the disease (carcinoma in situ). Currently, HPV DNA tests (generic tests) are now the most useful tests for HPV infection. The success of these testing methods depends on post-test care and follow-up, in particular, immediate treatment for women who test positive can help them recover faster.
Tertiary Prevention
(Useful to all women as needed) includes screening, treatment for invasive cervical cancer and palliative care. Diagnosis is made using a biopsy of uterine lesions followed by imaging (PET-CT). Squamous cell carcinoma focused on histology, but adenocarcinoma or small cell neuroendocrine cancer is present. Treatment is based on the histological diagnosis and stage, with early-stage tumors being treated with surgery, chemotherapy, and radiation therapy, and advanced stages having therapy options other than chemotherapy. Molecular biomarkers such as PD-L1, TMB, MSI, NTRK, RET testing are used to determine whether a patient is suitable for immunotherapy or targeted therapy. Identifying the right treatment for the right patient is extremely important, especially in the early stages. This is called precision oncology.
Patients who are in the early stages of the disease and have failed treatment options and can no longer tolerate other treatments are offered palliative care, which is comfortable specialized medical care that relieves pain and eases symptoms. The aim of this care is to bring comfort to the patient and provide a reasonable quality of life.
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5 Ways to Prevent Cervical Cancer
To prevent cervical cancer, here are 5 ways to reduce the risk in brief:
1. HPV vaccination should be on time.
2. HPV testing should be promoted.
3. The test results should be properly monitored.
4. Symptoms should be monitored and accordingly advised by the doctor.
(Article courtesy – Dr. Amit Verma is Molecular Oncologist and Cancer Geneticist at Dr. AV Cancer Institute of Personalized Cancer Therapy and Research, Gurgaon)
