All Sophia could remember was waking up to the familiar smell of antiseptic and three pairs of eyes which she recognised as her friends’, peering down on her with apprehension written all over their faces. She recognised the cramping too just the same way it was a few months ago. It has become a regular experience for her to cramp badly during her periods, and some times, feel unexplainable pains in her pelvic area. Worse still, her menstrual bleeding is almost always heavy. She broke up with her boyfriend as having sexual relations with him was equally painful. However, the pain she felt around her lower abdomen that day was worse than she had ever felt before; like hot needle-pricks around her waistline. Sophia could not tell what she dreaded most: the antiseptic smell that enveloped the hospital room or the doctor’s report. Based on her family’s medical history, there is likely one illness or the other that is hereditary. She wasn’t cut out for any ‘bad news’. Her friends told her she’d passed out after complaining about the generalised body weakness and cramping she felt shortly before their group presentation; and clearly had to rush her off to the hospital.
Results from the tests carried out reveal that Sophia has cervical cancer. Unfortunately, it has passed the first stage. In spite of the fact that she commenced treatment immediately, Sophia often wonders if there was anything she would have done differently to prevent the cancer. She also pondered if her case would have been redeemable had she reported her symptoms to a doctor, and maybe had a cervical screening done on time.
What is Cervical Cancer and how does it develop?
Cervical cancer is the fourth most common cancer. It accounts for about 60% of cancer-related deaths in women worldwide. According to the World Health Organization, an estimated 570,000 women were diagnosed with cervical cancer worldwide and about 311,000 women died from the disease in 2018.
Cervical cancer develops in a woman’s cervix. The cervix is a part of the female reproductive system that links the uterus to the vagina. It is the narrow outer end of the uterus and the beginning of the vagina. The cervix is often the site of most common cancers in women- squamous cell carcinoma.
A Pap smear (also called a Pap test) is a screening procedure for cervical cancer that tests for the presence of precancerous or cancerous cells on the cervix.
During the routine procedure, cells from cervix are gently scraped away and examined for abnormal growth. Though may be mildly uncomfortable, it usually doesn’t cause any long-term pain. Symptoms such as unexpected vaginal bleeding, discomfort & difficulty in passing urine, painful coitus and positive abnormal cell growth on the cervix following a Pap test is confirmatory of cervical cancer. However, it is worthy to note that the test doesn’t detect other sexually transmitted infections (STIs).
Causes and Risk Factors
Amongst possible risk factors of cervical cancer, infection with the high risk Human Papilloma virus (HPV) is the commonest. HPV Serotypes 16 and 18 have been identified with 98% of cervical cancer cases and are easily transmitted through sexual contact with an infected person.
Other risk factors for developing cervical cancer often stem from modifiable and non-modifiable factors.
Modifiable factors refer to lifestyle choices and they include: early age of first sexual intercourse, cigarette smoking, sexual intercourse with multiple partners, dietary choices such as increased intake of processed foods, excessive alcohol consumption, and sedentary lifestyle.
Unmodifiable risk factors are late menopause, early onset of menstruation, weak immune system following chemotherapy, organ transplantation or underlying health challenges like Diabetes mellitus, HIV positive females, age factor (peak incidences ranging between 23 and 45 years of age), and familial history of the disease.
Furthermore, persistent/recurrent infection with lower risk HPV serotypes with failure to resolving spontaneously can lead to cervical cancer.
Can Cervical Cancer be prevented?
The Centre for Disease Control (CDC) asserts that up to 93% of cervical cancers are preventable. To help prevent cervical cancer, it is recommended that girls who have attained puberty should receive Human Papilloma virus (HPV) vaccination. Health organizations controlled by both government and private bodies should carry out awareness and sensitizations in order to demystify the prevalence of cervical cancer and the possible factors that predisposes one to the disease, as it may vary based on many factors including age and vaccine availability. The American Cancer Society recommends that females between the ages of 25 and 65 should visit hospitals and get properly screened twice every five years.
Thorough screening exercises should be conducted in both urban and rural areas with more focus on the rural settlements where there’s limited access to adequate healthcare.
Furthermore, women and girls should employ additional effective means of protecting themselves against cervical cancer. Some measures found to effectively reduce the chances of contracting the disease include:
- Delaying first sexual intercourse until the late teens or older.
- Practicing safe sex and sexual responsibility.
- Avoiding sexual intercourse with people with questionable sexual and medical histories.
- Limiting the number of sexual partners
- Not engaging in sexual intercourse with people who are infected with genital warts or who show other symptoms.
- Quitting cigarette or tobacco smoking.
- Avoiding excessive alcohol consumption.
- Routine consultation with your gynaecologist.
When diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and efficiently managed. Effective primary (HPV vaccination) and secondary prevention strategies (screening for, and treating precancerous lesions) will prevent most cervical cancer cases.
Cancers diagnosed in late stages can also be controlled with appropriate treatment and palliative care and can be eliminated as a public health problem within a generation.