Most countries, including Anguilla, use the month of January as Cervical Cancer Awareness Month. Cervical cancer or cancer of the cervix is a preventable condition but, sadly for us here in Anguilla, women still die from this disease every year. Cervical cancer is completely preventable if precancerous cell changes are detected and treated early.
What is cervical cancer?
Cervical cancer occurs when abnormal cells develop and spread in the cervix, the lower part of the uterus (womb). Most cases of cervical cancer are caused by a virus. In most women, when the cancer is found early and managed by a qualified health team, it is highly curable.
What are some symptoms of cervical cancer?
In the early stages many women with cervical cancer might not have any symptoms at all. As the cancer progresses, symptoms may include the following:
• Unusual vaginal discharge
• Vaginal bleeding between periods
• Bleeding after menopause
• Bleeding or pain during sex
What causes cervical cancer?
The human papillomavirus (HPV) is a large group of viruses. About 40 types can infect the genital areas, and some have high risk for cervical cancer. Most cases of genital HPV infections usually clear up on their own. If one becomes chronic, it can cause changes in the cells of the cervix. It is these changes that may lead to cancer. Worldwide, over 90% of cervical cancers are caused by an HPV infection.
HPV infections usually have no symptoms and go away on their own. Some types of the HPV virus may cause genital warts, but these are not the same strains linked to cervical cancer. It is important to note that genital warts will not turn into cancer, even if they are not treated. The dangerous types of HPV can stay in the body for years without causing any symptoms.
Preventing cervical cancer
Early detection is key in preventing cervical cancer. The Pap smear test has been available for many years for checking for cervical cancer and pre-cancer conditions. A Pap test, can find changes in the cells of the cervix that are not normal. It is now recommended that all females begin having Pap tests at age 21, regardless of when they become sexually active. Having a Pap test markedly reduces a woman’s chances of developing cancer of the cervix.
In some cases, it can be helpful to do an HPV test along with a Pap test. HPV tests actually find the “high risk” types of HPV that cause most cases of cervical cancer. The HPV test/Pap test combination is now the recommended way to check for cervical cancer in women age 30 and older, although it is still acceptable to check women over 30 with Pap tests alone.
HPV tests are not recommended for routine use in women under age 30. This is because HPV infections are very common among women in their 20s, but most of these infections are harmless and are quickly cleared by the immune system.
The frequency of screening tests will vary depending on individual risk factors. The frequency could vary from every six months to every three years. Even though screening for cervical cancer can occur less often, it is still important for you to see your healthcare provider annually for other female-related health care needs. Ask your provider what he or she recommends.
Cervical cancer and vaccines
Vaccines are now available to ward off the two types of HPV most strongly linked to cervical cancer. Cervarix and Gardasil vaccines require three doses over a six-month period. Studies suggest the vaccines are effective at preventing chronic infections with the two types of HPV that cause 70% of cervical cancers. Gardasil also protects against two types of HPV that cause genital warts. The vaccines are not yet available in Anguilla as part of the National Vaccination Programme. It will take greater public pressure from various groups, and a change by the policy deciders, to get the vaccines available in our public health system. There is no doubt that the introduction of HPV vaccines will save lives.
Who should get the HPV vaccine?
The vaccines are only used to prevent, not treat, HPV infection. They are most effective if administered before an individual becomes sexually active.
Cervical cancer awareness
Unlike breast cancer, cervical cancer does not get the support and attention of large numbers of the general public in Anguilla and indeed in many other countries. There are few NGOs out there championing the need for greater awareness of cervical cancer and the need for women to get screened. Much more is needed to draw attention to the serious impact of cervical cancer on the lives of many women in Anguilla. Efforts must continue to prevent women from dying from this largely preventable cancer. Let us use the month of January to bring greater awareness to cancer of the cervix. We can make a difference.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
