In South Africa, cervical cancer is the second most common cancer with an overall incidence rate of 30 per 100 00 per year with the highest rate among black women aged 66-69 years.
What is Cervical Cancer?
Cervical cancer is the development of abnormal cells of the cervix also known in layman’s terms as the mouth of the uterus. The cervix, just like all other parts of the body, is made up of different tissues.
The cancer producing agents disturb the genetic coding of the cervix and abnormal cells develop, which after some time can form a malignant tumour (cancerous growth). If the abnormal cells are found only within the outer surface of the cervix the condition is called a precancerous lesion. Once malignant cells penetrate through the basement membrane (deeper tissues) this is then known as cervical cancer and it can then spread to the rest of the body.
Human Papilloma Virus
The Human Papilloma Virus(HPV) is the main agent involved in the development of cervical cancer or precancerous lesions. HPV is a family of very common viruses that cause almost all cervical cancers, plus a variety of other problems like common warts or genital warts.
Two high-risk types of HPV (16 and 18) are responsible for most cervical cancers and account for approximately 70% of cervical cancers. The virus which is mainly responsible for cancer of the cervix is spread through sexual contact or can be transmitted from mother to child as the baby passes through the birth canal. Other possible cofactors responsible for cervical cancer include cigarette smoking, immunosuppression (for example, HIV/Aids) and hormonal factors.
The Symptoms
In the initial phases there are usually no symptoms that may indicate one has cervical cancer. A pap smear, which is done as a screening test, can thus pick up the development of abnormal cells and also allow early intervention.
Other symptoms to look out for include vaginal bleeding which may start and stop between your regular menstrual cycle, bleeding after intercourse or even bleeding after your gynaecological exam.
Pap Smear
A pap smear is a screening test where the cells lining the cervix are examined under a microscope to look for any abnormal cells. A few cells of the cervix are gently taken from the cervix using a small brush and then analysed.
It is recommended that any sexually active woman must get a pap smear. If a woman is over the age of 40 years then a pap smear must be done annually, under 40 years it may be done every three years unless she is HIV positive in which case it must be done annually.
Vaccination in Preventing Cervical Cancer
Currently there are two vaccines aimed at targeting HPV and preventing cervical cancer. They are most effective when given to someone who has not been infected with HPV; so it is recommended that girls from the age of 9-25 years be vaccinated.
Clinical trials conducted over the years have shown that the vaccine is 100% effective in preventing cancer of the cervix. The vaccine costs approximately R2100 for the 3 doses. Unfortunately the vaccine is presently not available in state hospitals due to costs.
Preventing Cervical Cancer
Regular pap smears are crucial in the prevention of cervical cancer. Condom use can also prevent the spread of HPV which can lead to cervical cancer.
The best method to protect oneself against cervical cancer is the current vaccine together with regular pap smears. Remember, cervical cancer is 100% preventable.
