Cervical cancer is the second most common cancer among Indian women accounting for about 18 percent of all cancers occurring in this population group.
Dr. Neha Kumar, Senior Consultant, Gynecological Oncology, Amrita Hospital, Faridabad, says that every year, more than 1,20,000 new cases of this disease are diagnosed out of which more than 77,000 cases die due to diagnosis in advanced stage of cancer. This brings the death rate to about 63 percent, doctors said.
A major reason for the high burden of cervical cancer in India is lack of awareness and lack of cervical screening. Morbidity and mortality are the main causes of cervical cancer due to late detection and lack of access to necessary treatment.
In contrast, early screening for the disease can help find cervical changes before cancer develops. It can detect cervical cancer before malignant cells spread and is suitable for curative treatment.
Almost all cases of cervical cancer can be attributed to persistent human papillomavirus (HPV) infection. Other risk factors are early marriage, multiple sex 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 signs or early signs of cervical cancer include irregular vaginal bleeding, bleeding between periods or after intercourse, post-menopausal bleeding and foul-smelling vaginal discharge. Some patients may experience lower abdominal pain or cramping,” he added.
Conventional methods of cervical screening require Pap smears and HPV tests that require pathology and laboratory services that may not be available in all parts of the country, especially in remote and rural areas.
An effective way to screen women in this region is by methods known as VIA (Visual Inspection with Acetic Acid) and VILI (Visual Inspection with Lugol’s Iodine). These procedures use substances like acetic acid and Lugol’s iodine to look for changes in the cervix that are detectable with the naked eye, Dr. Kumar said.
Using this, one can detect abnormalities in the cervix, if any, and such patients can be referred to gynecologists at district hospitals for cervical biopsy and subsequent management.