Cancer of the cervix means cancer occurring at the mouth of uterus. Cervical cancer is the second most common cancer found in Indian women. India has a population of approximately 365.71 million women above age 15, who are at risk of developing cervical cancer. As per recent estimates, approximately 1,32,000 new cases have been diagnosed and 74,000 deaths occur annually in India, accounting to nearly 1/3rd of global cervical cancer deaths.
Indian women face a 2.5% cumulative lifetime risk and 1.4% cumulative death risk from cervical cancer.
In the past, it was believed that this cancer occurs in women who belong to low socio-economic strata. However, it has been observed that the cases are increasing in women belonging to higher socio-economic strata as well.
Higher incidence of cervix cancer is attributed to multiple sex partners, early age of sexual contact and viral infection, human papillomavirus infection (HPV). Other factors include unhygienic sexual practices, ignorance about proper cleaning of genitals, paucity of proper toilets, inadequate bathing facilities. Additionally, sedentary lifestyle, consumption of unhealthy food and smoking has also contributed to its rise.
Screening, with routine gynaecological check-up, PAP smear and / or colposcopy, helps in early diagnosis. Curative treatment can be offered in early stages with the help of a surgery, radiation, or combination of both.
In late stages, chemotherapy may be required along with surgery or radiotherapy. Most hospitals are equipped to treat these cancers effectively without impacting quality of life. However, minority of patients may have to visit centres which excel in cancer treatment like Asian Cancer Institute or regional cancer centres.
Recently, addition of minimal invasive surgical techniques like laparoscopy and robotic surgery in existing facilities has reduced hospital stay.
Educating young children and parents about anti-HPV vaccine, proper hygienic precautions, cleanliness of genitals during menses and otherwise is expected to reduce prevalence of cervical cancer. Healthy diet, exercises and avoiding tobacco consumption in any form has shown positive impact in its prevention too.
Lastly, significant number of women do not bother to know the result of PAP smear and do not continue their follow-up treatment. As a part of cervical cancer prevention strategy, there is an urgent need of awareness programmes not only to motivate women to get screened routinely, but also to ensure follow-up treatment is done.
In my opinion, Swachch Bharat campaign will reduce the incidence of cancer occurring due to unhygienic conditions.
The author is a Professor of Genitourinary (GU) / Gynaecologist (GYN), Oncology and Robotic Surgery, Asian Cancer Institute