Cervical Cancer and its Prevention: All You Need to Know

Cervical cancer can affect individuals with a cervix, particularly those aged 30 and above. Prolonged exposure to specific strains of human papillomavirus (HPV) is the main causative factor for cervical cancer development. Early detection significantly improves treatment outcomes, ensuring favorable long-term survival rates and maintaining a high quality of life.

Cervical cancer is a significant health concern affecting women globally, characterized by the abnormal growth of cells in the cervix, the lower part of the uterus. It is one of the most prevalent cancers among women, with approximately 604,000 new cases and 342,000 deaths reported globally each year, particularly in low- and middle-income countries where awareness and access to screening and preventive measures are limited. Despite being highly preventable and treatable when detected early, cervical cancer remains a leading cause of cancer-related deaths in women worldwide.

Understanding Cervical Cancer:

Cervical cancer develops slowly over time, typically starting with precancerous changes in the cells of the cervix. These changes are often caused by persistent infection with certain types of human papillomavirus (HPV), a common sexually transmitted infection. While most HPV infections resolve on their own, persistent infection with high-risk HPV types can lead to the development of cervical cancer.

In its early stages, cervical cancer can be asymptomatic. However, as the cancer progresses, various signs and symptoms may manifest, including:

• Vaginal bleeding following sexual intercourse, occurring between menstrual periods, or post-menopause.
• Menstrual bleeding characterized by increased heaviness and prolonged duration.
• Watery, bloody vaginal discharge, often accompanied by a strong odor.
• Pelvic discomfort or pain, particularly during sexual intercourse. 

Who is at risk?

 Risk factors for cervical cancer include:

1. HPV Infection: The primary cause of most cervical cancers is HPV virus infection, which can be transmitted through sexual contact.
2. Smoking tobacco: Smoking raises the risk of cervical cancer by prolonging HPV infections.
3. Multiple sexual partners: Having a higher number of sexual partners, as well as your partner having multiple partners, increases the likelihood of contracting HPV, thereby elevating the risk of cervical cancer.
4. Early sexual activity: Engaging in sexual activity at a young age heightens the risk of HPV infection, thereby increasing the risk of cervical cancer.
5. Other sexually transmitted infections (STIs): Contracting other STIs such as herpes, chlamydia, gonorrhea, syphilis, or HIV/AIDS can raise the risk of HPV infection, consequently increasing the risk of cervical cancer.
6. Weakened immune system: Individuals with weakened immune systems due to underlying health conditions are at a higher risk of developing cervical cancer if infected with HPV.
7. Exposure to miscarriage prevention medicine: Prenatal exposure to a drug called diethylstilbestrol (DES), administered in the 1950s to prevent miscarriages, is associated with an increased risk of a specific type of cervical cancer known as clear cell adenocarcinoma.
8. Other factors: Use of birth control pills, significantly longer than five years, and multiple (3 or more) pregnancies increase the risk of cervical cancer in women.

Treating Cervical Cancer:

Treatment for cervical cancer depends on various factors, including the stage of the disease, overall health, and patient preferences.

• Non-surgical treatment options for cervical cancer include radiation therapy, chemotherapy, and targeted therapy. Radiation therapy, either alone or in combination with chemotherapy, is often used to treat early-stage cervical cancer or as part of the primary treatment for locally advanced disease. Chemotherapy and targeted therapy may be used to shrink tumors, control symptoms, or improve outcomes in advanced or recurrent cervical cancer cases.
• Surgical interventions may include:

·        Laser surgery: Uses a laser beam to remove cancer cells.

·        Cryosurgery: Freezes cancer cells.

·        Cone biopsy: Removes a cone-shaped tissue from the cervix.

·        Simple hysterectomy: Removes the uterus but not surrounding tissues.

·        Radical hysterectomy with pelvic lymph node dissection: Removes uterus, parametrium, cervix, upper vagina, and pelvic lymph nodes.

·        Trachelectomy: Removes cervix and upper vagina but not uterus.

·        Pelvic exenteration: Removes bladder, vagina, rectum, and part of colon if cancer has spread.

Prevention of Cervical Cancer:

 Preventing cervical cancer involves a multi-faceted approach that includes vaccination, screening, and behavioral modifications. It encompasses three levels: primary, secondary, and tertiary prevention:

• The primary prevention strategy is vaccination against HPV, which protects against infection, with the most common high-risk HPV types responsible for cervical cancer. Routine HPV vaccination is recommended for adolescents before they become sexually active. It also involves educating and promoting safer sexual practices, such as using condoms and limiting sexual partners.
• The second stage involves cervical cancer screening, typically done using the Pap smear or HPV testing, to detect precancerous changes or early-stage cancerous lesions in the cervix. Early detection allows for timely intervention and treatment, reducing the risk of progression to invasive cervical cancer. Women should undergo regular cervical cancer screening according to recommended guidelines based on their age and risk factors.
• Tertiary prevention aims to prevent cancer recurrence or progression in individuals diagnosed with cervical cancer through appropriate treatment and follow-up care.

Ø  Preventing Cervical Cancer at Home:

While vaccination and screening are crucial for cervical cancer prevention, certain lifestyle modifications can also reduce the risk.

Eat Healthy: Maintaining healthy dietary habits with a balanced diet rich in fruits, vegetables, and whole grains can support overall health and reduce cancer risk. Certain foods may have protective effects against cervical cancer due to their anti-inflammatory and antioxidant properties. These include fruits such as berries, citrus fruits, and tomatoes, which are rich in vitamins, minerals, and phytochemicals. Vegetables like cruciferous vegetables (e.g., broccoli, cabbage, Brussels sprouts) and leafy greens (e.g., spinach, kale) are also beneficial. Consuming a diet high in fiber and low in processed foods and red meat may help reduce the risk of cervical cancer.

Exercise Daily: Regular physical activity, such as walking, is beneficial for overall health and may reduce the risk of certain cancers, including cervical cancer. Physical activity helps maintain a healthy weight, strengthens the immune system, improves circulation, and reduces inflammation, all contributing to cancer prevention. While walking alone may not prevent cervical cancer, it is an essential component of a healthy lifestyle that supports overall well-being and reduces the risk of chronic diseases, including cancer.

Follow Healthy Lifestyle: Avoiding tobacco use, practicing safe sex, and limiting exposure to known carcinogens can contribute to cervical cancer prevention.

Conclusion:

Cervical cancer is a significant public health issue with a considerable impact on women's health worldwide. While it remains one of the most prevalent cancers globally, it is highly preventable through vaccination, screening, and lifestyle modifications. By increasing awareness, promoting HPV vaccination, ensuring access to cervical cancer screening, and adopting healthy behaviors, we can reduce the burden of cervical cancer and improve outcomes for women at risk. Collaboration between healthcare providers, policymakers, and communities is essential to implementing comprehensive cervical cancer prevention and control strategies and ultimately achieving the goal of eliminating cervical cancer as a public health threat.

References:

1.WebMD [Internet]. Cervical Cancer. Available from: https://www.webmd.com/cancer/cervical-cancer/cervical-cancer