In India, cervical cancer is the second most common cancer among women. India contributes to one fourth of the global deaths due to cervical cancer making it a matter of concern.
What Is Cervical Cancer?
Cervical cancer is a type of cancer that begins in the cells of the cervix—the lower part of the uterus that connects to the vagina. It often develops slowly through abnormal cell changes called dysplasia. The main cause is usually a long-lasting infection with certain types of human papillomavirus (HPV). Early stages may show no symptoms, but unusual vaginal bleeding can be an early sign.
How Cervical Cancer Develops in the Body
The most common culprit is the human papillomavirus, HPV. Nearly all people who are sexually active will become infected with HPV at some point in their lives.
Although the majority of infections heal on their own, a few factors raise the possibility of HPV infection persisting and developing into cervical cancer. These include using birth control tablets regularly, obesity, smoking, and compromised immune systems.
Cervical cancer develops gradually when healthy cells in the cervix begin to change, often due to a persistent HPV infection. These abnormal cells, known as dysplasia, may remain noncancerous for years.
If not treated, the abnormal cells can turn cancerous and invade deeper cervical tissues. Over time, the cancer may spread to nearby areas like the uterus, vagina, or lymph nodes.
Types of Cervical Cancer
There are two main types of cervical cancer: squamous cell carcinoma and adenocarcinoma.
- Squamous cell carcinoma begins in the flat cells lining the cervix’s outer surface and makes up about 80–90% of cases.
- Adenocarcinoma starts in the glandular cells of the cervix and accounts for 10–20%.
- A rarer type, adenosquamous carcinoma, contains both cell types and is treated similarly.
Common Symptoms of Cervical Cancer
Common cervical cancer symptoms include unusual vaginal bleeding (after sex, between periods, or after menopause), abnormal vaginal discharge, and pelvic pain or pain during sex.
As the disease advances, signs may include leg swelling, back or abdominal pain, and urinary or bowel issues.
Early Warning Signs
Early signs of cervical cancer can include
- Unusual vaginal bleeding
- Persistent urinary tract infection (UTI)
- Leg swelling
- Bone pain
- Pelvic pain
- Urinary incontinence or blood in the urine
- Unexplained weight loss
When to See a Doctor
Consult a doctor if you experience vaginal bleeding outside your regular period, after menopause, or after sex, as well as persistent pelvic pain or unusual discharge.
While these symptoms may be caused by other conditions, it’s important not to ignore them, as early diagnosis improves the chances of effective treatment.
Early detection and timely medical intervention can greatly improve outcomes in cervical cancer cases. If you’re looking for specialized care, explore our Cervical Cancer Treatment services in Ahmedabad for expert consultation and personalized treatment plans.
How a Pap Smear Test Helps
Pap smear test is a common test used to detect the early signs of cervical cancer in the cells.
A Pap smear helps detect abnormal or precancerous cervical cells before they develop into cervical cancer. It can also identify infections or inflammation, allowing for early intervention and improved outcomes.
It is a quick, simple test with no recovery time needed.
What to Expect During the Test
During the test, you’ll lie on an exam table with your feet in stirrups. A speculum is used to open the vagina, and a small brush or spatula collects cervical cells for lab analysis.
- For a Pap test, the sample is examined to see if abnormal cells are present.
- For an HPV test, the sample is tested for the presence of the most common high-risk HPV types. Usually, the sample taken for the Pap test also can be used for the HPV test.
How Often Should You Get Screened?
It is recommended that you begin screening at age 21, regardless of when you begin having sex. The frequency and type of cervical cancer screenings are determined by your age and medical history.
- Women aged 21–29 should get a Pap test every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
- From 30–65, options include an HPV test every 5 years, a Pap test every 3 years, or both (cotest) every 5 years.
Preventive Measures
Regular screenings, safe sexual practices, and vaccination against HPV help reduce cervical cancer risk.
HPV Vaccination
Six HPV vaccinations are available worldwide. All have been demonstrated to be safe and effective in preventing HPV infection and cervical cancer, and they offer protection against the high-risk HPV strains 16 and 18, which are responsible for the majority of cervical malignancies.
It is encouraged that vaccination for girls aged 9 to 14 years should be done as a preventive measure against cervical cancer. The vaccine is very effective when given before a person becomes sexually active.
The vaccine can also be taken by all girls and women even after they have become sexually active as it will still boost their immune system’s ability to fight HPV and cervical cancer.
The vaccine may be given as 1 or 2 doses. People with reduced immune systems should ideally receive 2 or 3 doses.
It should be noted that even vaccinated individuals should follow screening guidelines.
Lifestyle Modifications
Beyond vaccination and screening, lifestyle choices reduce risk.
Practicing safe sex, including consistent condom use and limiting sexual partners, lowers HPV exposure. Condoms, which prevent some sexually transmitted diseases, can decrease the risk of HPV transmission. Avoiding multiple partners can reduce the chances of being exposed to HPV.
Quitting smoking is also vital, as it increases cervical cancer risk and can hinder the body’s ability to clear HPV infections. People who smoke or breathe in secondhand smoke have an increased risk of developing cervical cancer. The risk increases the more a person smokes or is exposed to secondhand smoke.
Maintaining a healthy weight is another preventive measure. Obesity is not only a risk factor for cancer but also makes detection of cervical cancer more difficult. This can lead to late diagnosis.
Medical Expert Opinion: Gynecologist Speaks on Importance of Early Detection
Tackling cervical cancer in India is the need of the hour.
Cervical cell alterations often take three to seven years to develop into cancer. These alterations may be identified by cervical cancer screening before they develop into malignancy.
Cervical cancer can be detected early using a variety of screening tools, including cytology, visual-based methods, and testing for high-risk HPV.
Precancerous lesions can be found with routine screening with Pap smears or HPV tests, allowing for early intervention and the prevention of cancer.
Most women should have cervical cancer screening on a regular basis.
Sources and Medical References
The World Health Organisation (W.H.O.) guidelines for cervical cancer are as follows:
- It recommends an HPV DNA based test as the preferred method, rather than visual inspection with acetic acid (VIA) or cytology (commonly known as a ‘Pap smear’), currently the most commonly used methods globally to detect pre-cancer lesions.
- It recommends starting regular cervical cancer screening maximum at the age of 30 years among the general population of women
- After the age of 50 years, WHO suggests screening is stopped after two consecutive negative screening results.
- Priority should be given to screening women aged 30–49 years in the general population of women.
Disclaimer and When to Consult a Doctor
A crucial first step is identifying symptoms and getting medical help for any pertinent red flags.
Women must to consult a doctor if they notice:
- Unusual bleeding during menstruation, after menopause, or after sexual activity
- increased or odorous vaginal discharge
- symptoms such as chronic back, leg, or pelvic pain
- exhaustion
- appetite loss
- soreness in the vagina
- leg swelling
Frequently Asked Questions
Most cervical cancers are not hereditary. They are primarily caused by HPV infections. However, rare types like embryonal rhabdomyosarcoma and minimal deviation adenocarcinoma may have genetic links, such as mutations in the DICER1 or STK11 genes. While having a close relative with cervical cancer may slightly increase risk, it’s usually due to shared environmental factors rather than inherited genes.
The Pap smear test has a sensitivity of about 55% to 80% for detecting high-grade lesions on a single test, and around 70% to 80% when using LSIL as the test threshold with CIN 2–3 as the reference. Its specificity can reach up to 95%. Accuracy improves with regular testing, proper specimen collection, and trained professionals.
Yes, cervical cancer can be cured if caught early. Early-stage cervical cancer has a high survival rate, with about 95% of patients with stage IA and 90% with stage IB1 surviving five years after diagnosis. Treatment options like surgery, radiation, or chemoradiation are highly effective. Regular screening and early detection are key to successful treatment and long-term survival.
