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As we commemorate Cervical Cancer Awareness Month this January, it becomes paramount to shed light on a significant quandary faced by India — cervical cancer, ranking as the third most prevalent cancer and contributing to 18.3% of morbidity and mortality. This predicament is predominantly attributed to low literacy rates, insufficient screening infrastructure, and societal stigmas. During this observance, it is imperative to underscore the imperative nature of raising awareness regarding the indispensability of both men and women receiving vaccination against the human papillomavirus (HPV).
In delving into this subject, let us scrutinize the indicators signaling the onset of cervical cancer and the crucial role vaccination plays.
Ten Premature Indicators of Cervical Cancer Demand Attention
According to insights from Dr. Nikhil Kalyani, a luminary in the Department of Radiation Oncology at Jaslok Hospital and Research Centre, Mumbai, cervical cancer stands as the most prevalent cancer in Indian women following breast cancer. Although its incidence is gradually diminishing in urban locales, it continues to cast a substantial shadow over rural areas. The mortality associated with cervical cancer is intricately tied to the stage of detection. While Stage I and II boast high cure rates, the efficacy dwindles for Stage III and IV. This underscores the paramount significance of early detection and intervention in the context of cervical cancer.
Dr. Kalyani outlines a set of warning signs indicative of cervical cancer. Should any of these manifestations manifest, seeking the evaluation of a gynecologist or oncologist is imperative.
- Post-coital vaginal bleeding
- Post-menopausal vaginal bleeding
- Excessive menstrual bleeding
- Vaginal bleeding between menstrual cycles
- Persistent foul-smelling vaginal discharge with blood
- Aching lower back
- Pelvic pain during intercourse
- Blood in urine or painful urination
- General fatigue
- Swelling or edema in both legs
Dr. Kalyani emphasizes that the most alarming symptoms are post-menopausal and post-coital vaginal bleeding, warranting immediate attention and evaluation by a qualified physician.
HPV and Its Association with Cervical Cancer
Dr. Sarika Gupta, a distinguished Consultant in Gynae-Surgical Oncology at Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), elucidates the role of human papillomaviruses (HPVs) in this context. Comprising over 200 related viruses, some of which are transmitted through various forms of intimate contact, high-risk HPVs can precipitate diverse cancers. Of the 12 high-risk viruses, HPV 16 and 18 are culpable for the majority of HPV-related cancers, including cervical cancer, anal cancer, oropharyngeal cancer, penile cancer, vaginal cancer, and vulvar cancer.
Cervical cancer stems from persistent infections with high-risk HPVs, affecting cells in the body where HPV infiltrates. While most HPV infections resolve on their own without consequences, certain high-risk types persist, leading to the formation of cancerous cells.
Dr. Gupta underscores the criticality of HPV vaccination, particularly for adolescents before the initiation of sexual activity, to preemptively mitigate the risk of cervical cancer.
Cervical cancer predominantly afflicts women, yet immunizing both genders holds intrinsic value. The World Health Organization advocates monitoring 70% of women and 90% of girls by age 15, with a goal of treating 90% of diagnosed cases. A comprehensive approach incorporates HPV immunization into national health programs. In the Indian context, the HPV vaccine and cervical cancer screening play pivotal roles in averting cervical cancer.
Dr. Aman Priya Khanna, Co-founder and Medical Director of HexaHealth, a luminary in General, Laser, Bariatric, and Minimal Access Surgery, accentuates the necessity of HPV vaccination as a preventive measure against cervical cancer. Notably, cervical cancer claims one Indian woman’s life every eight minutes. The vaccine serves as a personal shield against HPV, the primary instigator of cervical cancer, while screening facilitates the early detection of potential threats, diminishing the risk and saving lives.
HPV in the Male Domain
Dr. Gupta sheds light on studies indicating that 1 in 5 men harbor HPV, serving as carriers and transmitting the infection to young girls. The infection rate among men remains relatively constant across age groups. Remarkably, men exhibit a low propensity for natural or acquired immunity, even after repeated exposures, establishing them as long-term reservoirs of infection. Detecting HPV carriers in men poses challenges due to the absence of a standard HPV test. Vaccinating boys emerges as a strategic move to curtail the prevalence of HPV carriers. Achieving widespread vaccination among both males and females contributes to herd immunity, safeguarding unvaccinated individuals from infection.