Cervical cancer is also known as cervix uteri is the fourth common cancer among women worldwide with an estimated 604,127 new cases and 341,831 deaths in 2020. It is the third most gynecologic cancer in Canada.
Risk Factors:
Risk factors could be a behavior, substance, or condition that increases the risk of developing cancer. Human Papillomavirus (HPV) is associated with 99.7% of cervical cancer cases. In which approximately 70% of invasive cervical cancers are attributed to HPVs 16 or 18. Several other cofactors are likely to be involved in the disease process. Such as early onset of intercourse, multiple sexual partners, high parity, history of sexually transmitted diseases, smoking, alcoholism, immunocompromised state, lower socioeconomic status, hormonal contraceptives, and poor diet. Precancerous conditions of the cervix include squamous intraepithelial lesions (SILs). It can sometimes become cervical cancer if it isn’t treated.
Signs and Symptoms:
In the early stages, cervical cancer may not cause any signs or symptoms. Once the tumor grows into surrounding tissues and organs symptoms often appear. The first manifestation of early invasive disease is abnormal vaginal bleeding. As the lesion progresses, the vaginal discharge becomes more pronounced. Other symptoms of advanced disease may include long or heavy periods, anemia, loss of appetite, weight loss, shortness of breath, coughing up blood, chest or bone pain, fatigue, lumbosacral or gluteal pain, and lower extremity swelling. Advanced stage cervical cancer may present with urinary or rectal symptoms, including uremia progressing to coma. These symptoms are caused by a tumor that extends into the vagina, paracervical tissues, bladder, rectum, or lymph nodes.
Prevention:
Prevention is the key to decreasing new cases of cervical cancer. Prevention can be achieved via vaccination (primary) or screening (secondary), and treatment of precancerous lesions. There are 3 types of vaccines to protect against HPV infection in Canada –CERVARIX® (HPV2), GARDASIL® (HPV4), and GARDASIL® 9 (HPV9).
Cervarix protects against HPV16 and 18, the high-risk types associated with cervical cancer. Gardasil protects against HPV16 and 18, as well as HPV6 and 11, the types responsible for 90% of genital warts. Gardasil 9 protects males and females against 2 types of HPV that cause genital warts and 7 types of HPV that cause cancer, including types 16 and 18.
Females between 9 and 45 years of age can be vaccinated with Cervarix, Gardasil, or Gardasil 9 to prevent cervical cancer and precancerous cervical changes. They are administered through intramuscular injection 2 or 3 times over a 6- to 12-month period. The vaccines are safe, highly immunogenic, and effective in preventing HPV infection and high-grade cervical intraepithelial lesions.
Written by Rubina Polara