Prevention of Cervical Cancer

After breast cancer, cervical cancer is the second most prevalent form of cancer in women. 

According to the Lancet journal of global health, ~ 5,70,000 cases of cervical cancer are diagnosed in a year and 3,11,000 deaths are recorded in that year. Cervical cancer is the leading cause of cancer related death among women all over the world. 

This picture looks dismal but the silver lining is that cervical cancer is one of the few cancers for which there is a known definite cause and it can be prevented. 

Majority of the cases are caused after persistent infection with the human papillomavirus (HPV) which is an STD, usually acquired after sexual activity. 

So, timely diagnosis & treatment of HPV infection can help in the prevention of cervical cancer. Thus, it is a preventable and treatable type of cancer.  

As the age old saying goes, “prevention is better than cure”, there are some preventive steps that you can take to reduce your risk of developing cervical cancer.

What are the risk factors for cervical cancer? 

So, Any person with a cervix is at risk of developing cervical cancer. You can read all about cervical cancer in our article.

There are various factors that increase the likelihood of developing cervical cancer

• Having given birth to multiple children or pregnancy at an early age i.e under 17 years of age. 
• Early onset of sexual activity, before 18 years of age.
• Having multiple sexual partners.
• Reduced immunity due to HIV/ AIDS or any other immunocompromised condition.
• Unprotected sex, or having sex with someone who has genital warts / HPV infection.
• Having a history of vaginal, vulval, kidney or bladder cancer.
• Smoking also increases the risk to almost double those who do not smoke.
• Women who do not avail or do not have access to cancer screening/prevention strategies, low socio-economic status women are at a higher risk.
• According to some studies, the use of oral contraceptive tablets increases the risk.
• Exposure to diethystilbestrol (DES) before birth, i.e in the mother’s womb.

How can cervical cancer be prevented?

The origin of most cancers is multifactorial, ie they are caused due to a combination of multiple factors and you cannot always prevent cancers. However, this is one of the cancers that can be easily prevented with regular screening tests and vaccinations. 

With the growing use of pap smear testing and widespread vaccination, cervical cancer has become a receding public health problem. Various ways of preventing cervical cancer are:

1. Screening test

• The discovery of Pap’s smear test was revolutionary. This test helps to detect precancerous changes in the cells of the cervix that have the potential to develop into cancer if not treated. 
• Another screening test is HPV-DNA test which detects the presence of HPV, and the cause of the development of cancerous cells in the cervix. 
• Doctors recommend beginning Pap testing at the age of 21. For women aged 21 to 29 years, it is recommended to undergo a pap test every three years. For women aged 30 years and older, the pap test can be repeated every five years if combined with HPV test. 
• Women with risk factors may be advised to undergo these tests more frequently by their doctors. 

2. HPV Vaccination

• The Human papillomaviruses are of more than 200 types and are identified as mathematical numbers. Of these, the types 16, 18, 31 and 33  are the high-risk types of HPV that are more likely to lead to cervical cancer.
• HPV vaccine protects against cervical, vulval, vaginal, penile cancers and genital warts.
• There are 3 types of HPV vaccines available which are Cervarix (Bivalent), Gardasil-4(Quadrivalent), Gardasil-9 (Nanovalent).
• As the name suggests Cervarix protects against 2 types of HPV, Gardasil-4 against 4 types, and Gardasil-9 against 9 types of HPV.

• Vaccine is most effective when given before sexual exposure. 
• The ideal age to get vaccinated against HPV is 09-15 years, sometimes it may be extended to 26 years.
• You can discuss the possibility of getting the vaccine and its benefit with your doctor if you are between the age group of 27-45. It is not very beneficial to get the vaccine if you are in this age group, as exposure to HPV might have already occurred.  If you are above the age of 45, vaccination is not recommended. 
• If you are in the category of 09- 14 years, the vaccination is a two-dose schedule. The doses are given 06 months apart.
• Whereas, if you are within 15-26 years of age, the vaccine is given as a three-dose schedule. You will receive the 2nd dose 2 months after the first dose and 3rd dose six months after the first dose.
• Remember, that vaccines cannot cure cervical cancer. It can only be used to protect yourself from the HPV infection which is the leading cause of cervical cancer. 
• Remember not to replace the screening tests with vaccination. A combination of screening and getting the jab is an effective tool. 

You can read more about the cervical cancer vaccine in our article.

3. Lifestyle changes

• The easiest way to prevent cervical cancer is using condoms during sexual activity. It lowers the risk but does not completely protect you as the genitals are not fully covered and hence transmission of HPV from one infected partner to another is possible through skin contact. 
• Quitting smoking and limiting the number of sexual partners also helps to reduce the risk.
• Always be open to discuss the sexual history with your partner.

4. Dietary changes

Foods rich in flavonoids, folic acid, carotenoids are said to reduce the risk of cervical cancer as they enhance the body’s general immunity. 

• Foods rich in flavonoids are apple, broccoli, cabbage, garlic, onions, spinach. 
• Foods rich in folic acid are chickpeas, strawberries, orange juice. 
• Carrots, sweet potato, pumpkin are rich in vitamin A. 
• A healthy lifestyle should be combined with the other methods mentioned above as it cannot be effective alone to prevent cancer.

Cervical cancer is said to be a “lifestyle cancer” and having regular screening, getting thevaccination jab, eating healthy and following healthy sexual habits can prevent the cancer. 

Our goal should be zero cases of cervical cancer because it is achievable with the pathbreaking pap smear and getting the jab. So, if you haven’t gotten your cervical cancer vaccine yet, discuss the risk and benefit with your doctor , get it done and educate the people around you so that we can proceed towards the “zero case” goal.

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