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world health day , Health Update
Cervical Cancer is Preventable
Regular health screenings can ensure early detection and successful treatment for this deadly disease
CERVICAL CANCER is preventable with Regular Pap Screening
Pap smears are probably the most successful of all screening procedures ever devised to detect cancer early
With International Women’s Day being commemorated just last month, it is perhaps pertinent to examine one of the major global female health issues — cervical cancer. Carcinoma of the cervix is the second-leading cause of cancer death worldwide and the second most common life-threatening cancer among women after breast cancer. The statistics for the region show that there is an incidence rate of the disease of 4.8 per 100,000 women per year in the Middle East and 9.9 per 100,000 women in the UAE. The UAE’s Cancer Registry Program reveals that the annual average of reported cervical cancer cases tripled in 2005, when compared with the period 1998-2004.
Cervical cancer develops when abnormal cells in the lining of the cervix begin to multiply out of control. Abnormal cells can gather to form a lump, or tumour, which can be either benign or malignant. Benign (non-cancerous) tumours do not spread and are usually not harmful, whereas malignant (cancerous) tumours spread from their original source, with cells being moved to different parts of the body via the body’s circulatory and lymphatic systems.
Pre-cancerous changes and the early development of cervical carcinoma may well be symptom free, but as the disease progresses, women may notice one or more of the following symptoms; abnormal vaginal bleeding, bleeding that occurs between regular menstrual periods, bleeding that occurs after either intimacy, douching or a pelvic examination, bleeding after menopause, menstrual periods that last longer and are heavier than before, an increase in vaginal discharge, pelvic pain and pain while having relations.
Virtually all cervical cancers are caused by some type of Human Papillomavirus (HPV). This is a common organism that infects half of all people at some point in their lives, but more than two-thirds of cervical cancer cases are attributed to high-risk HPV types 16 and 18. In 2006, a vaccine against HPV, Gardasil, was introduced to help prevent medical conditions caused by HPV types 6, 11, 16 and 18; conditions that included cervical cancer. However, the vaccine is no substitute for routine cervical screening and women who receive it should continue to undergo this procedure.
Gaby Khayata MD, Obstetrician and Gynaecologist at the Sulaiman Al Habib Medical Centre in Dubai Healthcare City, explains why regular Pap screening can detect issues before they become life threatening. "With regular Pap testing, you can help prevent cancer of the cervix. Although the HPV vaccine helps to prevent the disease, it does not replace regular screening. In the early stages, cervical cancer may not show any symptoms, but if caught early, it is almost 100 per cent curable," he says. "The chances of detecting cervical cancer at an early stage are greatly increased by having regular Pap smears, hence, I always recommend my patients to have regular gynaecological checkups. Most importantly, the test is a very quick and hassle-free procedure that does not hurt and is a very simple step that could save your life," he adds.
About one-third of women who should have regular Pap tests don’t. Women who forego the screening at recommended intervals are far more likely to develop cervical cancer than women who regularly attend for the procedure. Between 60 per cent and 80 per cent of women newly diagnosed with cervical cancer have not had a Pap smear within five years, with some of these never having been tested.
As pre-cancerous changes and early cancers of the cervix generally do not cause pain or other symptoms, it is important to receive regular Pap screenings to detect these conditions at a stage when they can be treated most effectively. It is the increased use of the Pap test that is mostly responsible for the decrease in the number of cervical cancer deaths. The simple, highly effective screening procedure can detect pre-cancerous conditions of the cervix and more than 90 per cent of all cervical cancers. It is credited with significantly reducing cervical cancer deaths since its widespread introduction in the 1950s. Dr Khayata believes that the continued deaths associated with the disease are solely due to poor compliance with undertaking this simple, yet life-saving procedure.
"The fact that thousands of women die each year of a disease that can be prevented or cured reflects widespread failure to have Pap tests as often as we recommend," he says.
Risk Factors
We don’t know exactly what causes cervical cancer, but certain risk factors are believed to have an effect. Medical history and lifestyle play a role in a woman’s chances of developing cervical cancer. It is probable that several factors contribute to cervical cancer, such as:
Risk Factors
We don’t know exactly what causes cervical cancer, but certain risk factors are believed to have an effect. Medical history and lifestyle play a role in a woman’s chances of developing cervical cancer. It is probable that several factors contribute to cervical cancer, such as:
• Poverty: Women who are poor may not have access to medical services that detect and treat pre-cancerous cervical conditions. When these women develop cervical cancer, the disease usually remains undiagnosed and untreated until it has spread to other parts of the body. Women who are poor are often undernourished and poor nutrition can also increase cervical cancer risk.
• Pap test history: Not having regular Pap tests increases the chance of unrecognised cervical cancer. Between 60 per cent and 80 per cent of women with newly diagnosed cervical cancer have not had a Pap test in at least five years.
• Tobacco use: Women who smoke are about twice as likely to develop cervical cancer as women who do not. The more a woman smokes — and the longer she has been smoking — the greater the risk.
• Eating habits: A diet that doesn’t include ample amounts of fruit and vegetables can increase a woman’s risk of developing cervical cancer.
• Weakened immune system: A woman whose immune system is weakened has a higher-than-average risk of developing cervical lesions that can become cancerous. This includes women who are HIV-positive (infected with the virus that causes AIDS). It also includes women who have received organ transplants and must take drugs to suppress the immune system so that the body won’t reject the new organ.
• Hormonal medications: Some experts suggest that hormones in oral contraceptives (birth control pills) can make women more susceptible to Human Papillomavirus (HPV). At least one study has indicated that taking birth control pills significantly increases a woman’s risk of developing HPV-related genital warts. Other research suggests that using oral contraceptives for five years or longer slightly elevates a woman’s risk of developing cervical cancer, especially if she began taking the Pill before the age of 25.
• Diethylstilbestrol (DES): A rare type of cervical cancer has been diagnosed in a small number of women whose mothers took DES; a medicine that was once used to prevent miscarriage.
• Douching: Because douching may destroy natural antiviral agents normally present in the vagina, women who douche every week are more apt to develop cervical cancer than women who do not.
• Chemical exposure: Women who work on farms or in the manufacturing industry may be exposed to chemicals that can increase their risk of cervical cancer.
(Facts and numbers are referenced by the Mayo Clinic)
