Cervical Cancer Awareness Month in January

Cervical Cancer is cancer that starts in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina and accounts for 32% of cancer deaths in women in comparison to 8% caused by breast cancer.

In Africa there are 79 000 cases of cervical cancer per year and 62 000 deaths per year with one woman dyeing somewhere in the world every 2 minutes due to cervical cancer.

Cervical cancer usually develops very slowly and the precancerous condition called dysplasia can be detected by a Pap smear and is 100% treatable. Almost all cervical cancers are caused by HPV (Human papilloma virus) which is a common virus spread through sexual intercourse. There are many different types of HPV and some strains lead to cervical cancer, some may cause genital warts and others cause no problems at all. A woman’s sexual habits can increase her risk for cervical cancer including having sex at an early age, having multiple partners, having partners who participate in high-risk sexual activities and having sex without a condom. The other risk factors are having a baby before the age of 16, having other illnesses or using medication that suppresses your immune system and smoking.

Women aged 40 to 50 years are the most commonly diagnosed with cervical cancer and the incidence is higher among women from lower socioeconomic groups and among those with a history of early and frequent coitus and multiple sexual partners. Peak age at diagnosis is 47 years and most present with the advanced stage of the disease which has poor survival and high morbidity.

As most cases of cervical cancer are caused by the Human papilloma virus which is preventable by vaccine and curable at an early stage, vaccinating against HPV and screening are very important in preventing this type of cancer.

During the initial stage which can take 10 years to develop there are no symptoms but at this stage a Pap smear can detect 90% of early cervical neoplasias.

As the cancer progresses the following symptoms may occur:

  • Unusual vaginal discharge which may be pale, watery, pink, brown, bloody or foul-smelling
  • Vaginal bleeding between periods
  • Vaginal bleeding after menopause
  • Vaginal bleeding or pain during/after sex
  • Low backache
  • Periods that become heavier and last longer

Cervical cancer may spread to the bladder, intestines, lungs and liver and patients do not normally have any signs or symptoms until the cancer is advanced and spread.

For early detection Pap smears in women should be started from the age of 21 years if they are sexually active and then re-tested every 3 years. Early diagnosis and prompt treatment will cure nearly all cases of cervical dysplasia.

For prevention there is a vaccine against HPV and girls who receive this vaccine before they become sexually active (recommended from 10 years of age) reduce their chances of getting cervical cancer by 70%.

There are 2 different vaccines against HPV :

  • CERVARIX (bivalent vaccine) targets 2 HPV strains which are 16 and 18
  • GARDASIL (trivalent vaccine) targets 4 HPV strains which are 16, 18, 6 & 11

HPV strains 6 and 11 can cause genital warts and as yet there is not enough information to determine whether one of the 2 types of vaccine works better than the other at preventing cervical cancer.

CERVARIX vaccine has just become registered and hence readily available in Zimbabwe and is recommended in females from the age of 10 years for the prevention of cervical cancer by protection against incident and persistent infections caused by the Human papilloma viruses Type 16 and 18 which are the major causes of cervical cancer. The primary vaccination course consists of 3 intramuscular doses to be administered in the deltoid region at a 0, 1 and 6 month schedule and protection lasts for 5 years. Safety data shows no long term risks and serious side effects at the time of vaccination are lower than the rate for vaccines over all.

By

  • Getting vaccinated early
  • Having regular Pap tests and HPV tests

A woman has the best chance of preventing what is by far one of the most preventable cancers we have.

Speak to your Pharmacist or Doctor for more information.

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