Almost all of us here in Anguilla know of a mother, sister, aunt or grandmother who has been diagnosed with cancer of the cervix (mouth of the womb). This largely preventable cancer still affects many women in Anguilla and we must do more to educate the country about it.
Cervical cancer
According to the World Health Organization (WHO), cervical cancer is one of the world’s deadliest – but most easily preventable – forms of cancer for women, and is responsible for more than 270,000 deaths annually.
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body.
In Anguilla, cervical cancer is largely preventable – thanks to cervical screening. However, uptake of cervical screening is not what we would hope for. Early detection is also key in increasing survival rates and so educating everyone on the disease, its symptoms and ways to prevent it, is important.
What causes cervical cancer?
Cervical cancer, in 99.7% of cases, is caused by persistent infection with a virus called human papilloma virus (HPV). HPV is a very common virus transmitted through skin to skin contact in the genital area. Around 4 out of 5 people (80%) will be infected with HPV at some point in their lives. However, for the majority of women this will not result in cervical cancer. Cervical cancer is rare while HPV infection is common. It is important to stress HPV will not necessarily lead to cervical cancer.
The majority of cervical cancers are caused by a very common virus called human papilloma virus (HPV). Anyone who is sexually active can contract HPV through contact with someone who already has the virus. Most women are infected with HPV at some point in their lives but may never know they have been infected. Like other viral infections, such as a cold, HPV is usually cleared by the body’s immune system without the need for other treatment. We do not know why a small percentage of women do not clear the infection which can remain ‘dormant’ (inactive) in their bodies sometimes for many years. In a few women the virus may lead to the development of cervical cancer.
There are around 20 high-risk strains of HPV that are responsible for 99.7% of all cervical cancers. Within the high-risk group, strains 16 and 18 are the most prevalent and responsible for 70% of cervical cancers. HPV infection can cause changes to the cells of the cervix creating abnormalities. Once these abnormalities become severe they can develop into cancer. That is why cervical screening is important because it can detect early changes in the cells.
Cervical cancer prevention
Women from 21 or 25 years are encouraged to have screening for cervical cancer. The cervical smear test, also known as a Pap test, is a simple painless test that can be done in the doctor’s office. Regular cervical screening is the best way to identify abnormal changes in the cells of the cervix at an early stage. The frequency of smear testing will vary from one individual to another and your age is one factor that will determine the frequency of smear testing.
If you have been treated for abnormal cervical cell changes, you will be invited for screening more frequently for several years after treatment. How regularly you need to go will depend on how severe the cell change is.
Although it can spot most abnormal cell changes in the cervix, cervical screening is not always 100% accurate. Therefore, you should report symptoms such as unusual vaginal bleeding to your gynaecologist even if you have recently been tested.
Cervical cancer vaccination
The human papilloma virus (HPV) vaccination protects against the two strains of virus responsible for most cases of cervical cancer.
The vaccine is given to girls when they are 12 to 13 years old, with three doses given over a six-month period. Although the HPV vaccine can significantly reduce the risk of cervical cancer, it does not guarantee you would not develop the condition. You should still attend cervical screening tests even if you have had the vaccine.
Avoid smoking
You can reduce your chances of getting cervical cancer by not smoking. People who smoke are less able to get rid of the HPV infection from the body, which can develop into cancer.
Regular medical check-ups
In the early stages of cervical cancer there are few if any symptoms, but it is still important to see your gynaecologist and have regular pelvic exams and Pap testing, as these can detect precancerous changes in the cervix. Precancerous changes in the cervix may be treated with cryosurgery, cauterization or laser surgery. This will prevent cancer of the cervix from developing.
Identifying symptoms of cervical cancer
Treating cervical cancer in its early stages is associated with the best prognosis. Women and other relatives should know what to look for in individuals who might have cervical cancer. The most common symptoms and signs of cervical cancer are abnormal vaginal bleeding, increased vaginal discharge, bleeding after going through menopause, pain during sex and pelvic pain. These symptoms are associated with other disorders, so if you have them you should see your gynaecologist.
Conclusion
There is no single way to completely prevent cervical cancer, but there are a number of things that can help reduce your risk. In Anguilla cervical smear testing is the main way you can help prevent cancer of the cervix. If you need more information about cervical cancer prevention talk to your healthcare provider. Cancer of the cervix is one of the few cancers that we can prevent.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
