January is Cervical Cancer Awareness Month!!!

Did you know that cervical cancer is  most frequently diagnosed in women between the age of 35-44? The American Cancer Association estimates that in 2021 approximately 14,480 new cases of invasive cervical cancer will be diagnosed, and approximately 4,290 women will die from cervical cancer.

Cervix and its function:

The cervix is the lowest region of the uterus that connects the uterus to the birth canal and is about two inches long. The cervix widens during childbirth to allow the passage of baby. It also allows the passage of menstrual fluid and the sperms need to pass through the cervix in order to reach the uterus.

Cervical Cancer:

Most cervical cancers are caused by the Human Papilloma Virus (HPV). There are no signs or symptoms in the early stages of the cancer. Signs and symptoms of advanced stages include: vaginal bleeding after intercourse, between period or after menopause, watery fluid drainage that may be heavy and have a foul odor and pelvic pain or pain during intercourse.

Risk Factors:

1. Human Papilloma Virus (HPV): Can spread with skin to skin contact and sexual activity (vaginal, anal or oral)
2. Sexual history: Mostly due to early exposure to HPV. Becoming sexually active at young age (younger than 18), many sexual partners and one partner who is a high risk.
3. Smoking: Women who smoke are twice at a risk to get cervical cancer than non smokers.
4. Weakened immune system: The immune system is important in destroying cancer cells. Women with weakened immune system might have a precancer develop to an invasive one faster than normal.
5. Chlamydia infection: Certain studies show that chlamydia bacteria may help HPV grow and live on in the cervix which might increase the risk of cervical cancer.
6. Long term use of oral contraceptive: Research suggests that long term use of oral contraceptives may increase the risk of cervical cancer ,but the risk goes down once the pills are stopped.
7. Multiple full term pregnancies: Women with 3 or more births are at a high risk which is thought due to increased exposure to HPV and a possible weak immune system during pregnancy.
8. Young age at full term pregnancy: Women who had their first full term pregnancy under the age of 20 are at a higher risk.
9. Economic Status: Many low income women don’t have adequate access to healthcare services and may not get screened or treated for cervical pre cancers.
10. Diet: Women whose diet low in fruits and vegetables may be at a higher risk for cervical cancer.

Prevention and Early Detection:

Not all cervical cancers can be prevented but depending on the person’s age and overall health the risk can be reduced. Vaccination and regular screening can help detect/prevent cervical cancer in the early stages .

Prevention:

1. HPV vaccine: Helps protect children and young adults against some HPV infections. The American Cancer Society (ACS)recommends vaccination to children 9-12 and young adults between 13-26 who haven’t received all their doses. The ACS doesn’t recommend vaccine for people over the age of 26.
2. Limit exposure to HPV: HPV is passed via skin contact and can be passed without sex. It can spread from one body part to another. You can limit the exposure by limiting the number of sexual partners and avoiding sex with person who have had multiple sex partners.
3. Use a condom: Condoms can protect somewhat against HPV but can’t completely protect against it as it does not cover all the parts.
4. Quit smoking: Not smoking is another important way to reduce the risk of cervical cancer and pre-cancer.

Early Detection:

1. Pap test: Used to collect cells from the cervix to be tested in the lab for cancer and pre-cancer. Most invasive cervical cancers are found in women who don’t have a Pap test.
2. HPV test: Looks for infection by high risk types HPV that are more likely to cause cervical pre-cancer and cancer.

Statistics:

Once upon a time was one of the leading cancer to cause death in women in the United States. However, for the last 40 years with vaccine and early detection the number of cases and death due to cervical cancer have decreased significantly. Most frequently diagnosed in women between the age of 35-44 with average age of diagnosis being 50. More than 20% of cancer are found in women over the age of 65 who haven’t had regular screening tests .

References:

Cervical Cancer Statistics | CDC

The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer