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Treatable & preventable, yet cervical cancer rates soaring in India

IANS Jan 16, 2024

Cases of cervical cancer are significantly rising in India, even though it is both preventable and treatable, said doctors on 15th Jan, stressing the need to raise awareness on vaccination and early screening.

India accounts for 1 in every 5 or 21 per cent of cervical cancer cases, according to a recent study published in the journal The Lancet Global Health. The cancer also causes almost one in every four or 23 per cent deaths in the country.

The primary driver (95 per cent) of cervical cancer is persistent infection with specific strains of human papillomavirus (HPV). HPV, a prevalent virus transmitted through sexual activity, is encountered by at least half of sexually active individuals at some point in their lives. However, only a small percentage will develop cervical cancer as a result.

"Cervical cancer, a disease in which cells in the body grow out of control, primarily affects individuals with a cervix. Despite being preventable through vaccination and treatable if detected early, cervical cancer continues to pose challenges, especially in developing countries," Dr Manish Machave, Consulting Obstetrician, Gynaecologist & Gynaecological Endoscopic Surgeon, Ruby Hall Clinic, Pune, told IANS.

The doctor pointed out lack of awareness, incomplete vaccination, inadequate screening, cost and quality of treatment, and early marriage and multiple pregnancies as some of the reasons for rising cervical cancer rates in India, despite being a treatable and preventable disease.

"If we can vaccinate the children between the age of 9 years to 22 years among the females, all before attainment of sexual activity, in that situation, we can give this vaccination and prevent them getting infected with HPV, and so we can avoid the major chunk of population from getting cervical cancer," added Dr Pritam Kataria, Consultant Medical Oncology Sir H. N. Reliance Foundation Hospital.

"Also, early screenings help us to diagnose cervical cancer at an earlier age and help us to cure the cancer completely," he said.

Dr Kataria explained that pap smear testing may help identify an HPV infection, or changes in the mucosa or the lining of the cervix that can help diagnose cervical cancer very early. Experts also advised women to not overlook constant bleeding, spotting, and pelvic pain that can lead to cervical cancer.

"Constant bleeding, spotting between periods, or after menopause may indicate abnormal cell growth in the cervix; heavier and longer menstrual bleeding than usual could be a symptom of cervical cancer; watery, foul-smelling vaginal discharge may suggest an advanced stage of cervical cancer; pelvic pain or pain during intercourse may occur as the cancer progresses and affects nearby tissues", could be some of the red flags, Dr Machave said.

Other signs to be on the lookout for cervical cancer include, pain during urination or blood in urine, weight loss without apparent reason, fatigue, swelling in legs, back or leg pain, difficulty in controlling urine or bowel movements in advanced stages, the doctors said.

Cervical cancer can also spread to the spine and cause significant trouble. "Despite its prevalence, cervical cancer rarely metastasises to the spine, and when it does, it manifests as spinal epidural metastasis (SEM)," Dr Bibhudendu Mohapatra, Associate Director- Spine Services, Indian Spinal Injuries Centre, New Delhi told IANS.

"This occurrence is infrequent and typically associated with poorly differentiated carcinomas, spreading primarily through the bloodstream. If cervical cancer reaches the spine, it may lead to spinal cord compression, resulting in diverse nervous system symptoms affecting movement and sensation," he said.

The doctors recommended routine pap smear tests, starting at age 21, and repeating every few years. The suggested age to start the vaccination is between 9 and 12 years, and individuals can receive catch-up vaccinations until the age of 26.

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