Good advice is welcome at any time, specially when it comes to getting yourself screened for cancer. Because the earlier you detect cancer, the more successfully you can arrest it. For example, Stage 1 breast cancer and cervical cancer has a survival rate of more than 90% while Stage 3 is about 50% . In the case of ovarian cancer, Stage 1 has an 80% survival rate whereas Stage 3 has a survival rate of less than 20%.It is with figures like these in mind that women wing of IMA wishes to create public awareness on cervical cancer and focus on related social issues.
Cervical Cancer is a most common cancer in Indian women with 1.32 lakh new cases and 70,000 deaths every year. The risk factors for cervical cancer in India include multiple sexual partners, early sexual debut and male factors whereas religion, literacy rate and number of pregnancies do not seem to have a major bearing on cancer risk. However smoking, and other sexually transmitted infections go increase the risk of development of cervical cancer.
Screening for cervical cancer in an organized manner has been shown to reduce its incidence in the West to less than 1%. HPV infection is seen to be highest in the third decade of life, and is found in 75-85% of precancerous lesion and over 99% of cervical cancers.
The virus is transmitted through sexual contact and current estimates suggest that 50% of sexually active women have been infected with one or more types of HPV. A causal link between HPV infection and cervical cancer as well established. There is enough evidence which demonstrates beyond doubt that HPV infection is the first necessary cause of cervical cancer.
Prevalence
South Asia prevalence of HPV-16 infection is seen in over 50% women and for HPV -18 it is 25%.Prevalence of HPV infection is greatest (approximately 20%) in women aged less than 25 years and this virus can be acquired by mere skin-to-skin contact. Therefore anyone who has a normal sex life is at risk of exposure to high-risk HPV types. Condoms reduce the risk but are not fully effective.
Probability of Development of Cervical cancer
For every million women infected with high-risk HPV, 100,000 will develop cervical cytological abnormality on pap smear, 8000 will develop precancerous lesion and 1600 will develop invasive cervical cancer. Most people are exposed to high-risk HPV infections at some point. It is seen that the progressive development of cervical cancer from HPV infection takes place over 10 years period , though in few cases it could take place in just 1-2 years.
Cervical Cancer in India in relation to world statistics
The incidence of cervical cancer in India is 27% of the worldwide total or 125,952 cases. Morality is 70,528 deaths per year or 30% of the global total. HPV positivity is seen in 99.4% in cervical cancer specimens from Chennai. The overall 5 year survival rate for cervical cancer is 40%, this rate is influenced by clinical stage and treatment mode.
Preventing Cervical cancer
Screening
The ‘pap smear’ is cytology test that screens for cervical cancer and acts as a secondary prevention mechanism. However a large number of individual women will develop cervical cancer despite the screening programme is due to presence of big cervical erosion. Due to lack of health check ups and majority of women still having home deliveries and totally unaware , incidence of cervical cancer is still extremely high in Indian women.
The incidence of cervical cancer is increasing across the globe specially due to lack of screening facilities , and there is only a partially met need for the control of cervical cancer. There is no nationally organized cervical cancer screening programme in India as in west .
Indian public specially women should be made aware and conscious about annual gynaecological check up as most Indian women and girl students are unaware of cervical cancer risk and know nothing about its social issues. A study of more than 3,000 female students shows that they were no better informed about the disease than their male counterparts. Less than 1% could relate this cancer to be sexually transmitted.
Vaccination
Vaccination can also protect against HPV infection which is the proven necessary cause of cervical cancer. Vaccination is a primary prevention tool that can be used in young girls and women with no clinical evidence of disease and should be integrated in existing health services, once it is available in world market i.e late 2006,2007. Vaccination is already developed by one company and GSK ‘s vaccine is also in pipeline. It is to be given by intramuscular injection in a three-dose schedule over six months period.
Indian Medial Association remains committed for empowering you on health front at every step in life it requests all sexually active women to register themselves for screening today for cervical and breast cancer. |
