Cervical cancer is the second most common cancer in Indian women accounting for about 18 per cent of all cancers occurring in this demographic group.
Dr. Neha Kumar, Senior Consultant, Gynaecological Oncology, Amrita Hospital, Faridabad said that every year, over 1,20,000 new cases of this disease are diagnosed out of whom more than 77,000 cases succumb to death owing to diagnosis during advanced stages of the cancer. This brings the mortality rate to approximately 63 per cent, said the doctor.
A major cause of the high burden of cervical cancer in India is lack of awareness and lack of cervical screening. Morbidity and mortality owing to late detection and lack of access to required treatments constitute the driving evils of cervical cancers.
On the contrary, early screening of the disease can help find changes in the cervix before cancer develops. It can also detect cervical cancer before the malignant cells spread and is amenable to curative treatment.
“Nearly all cases of cervical cancer can be attributed to persistent human papillomavirus (HPV) infection. Other risk factors are marriage at a very young age, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, smoking, immunosuppression including HIV infection, prolonged use of oral contraceptives, and lack of awareness and screening,” Dr. Kumar said.
“Warning symptoms or early signs of cervical cancer include irregular vaginal bleeding, bleeding in between periods or after sexual intercourse, postmenopausal bleeding, and foul-smelling vaginal discharge. Some patients may also experience lower back pain or lower abdominal pain,” she added.
Cervical screening by conventional methods requires pap smear and HPV tests which require pathology and laboratory services that may not be available in all parts of the country, especially the remote and rural areas.
An effective way to screen women in these areas are by methods known as VIA (Visual Inspection with Acetic Acid) and VILI (Visual Inspection with Lugol’s Iodine). These methods use substances like acetic acid and Lugol’s iodine to see changes in the cervix which can be detected by the naked eye, Dr Kumar said.
Using this, one can identify abnormalities in the cervix, if any, and such patients can be referred to district hospitals to gynaecologists for cervical biopsies and further management.