Cervical cancer: prevention is better than cure
It is estimated that 3 700 South African women will lose their lives this year because of cervical cancer, one of few cancers for which there is a known cause, namely the human papilloma virus (HPV).
Cervical cancer is a life-threatening disease that will cause the death of more than 270 000 women throughout the world each year. To put this into perspective, worldwide every two minutes a woman dies as a result of cervical cancer.
However, cervical cancer may be prevented if correct and timeous action is taken. More than 50 countries have already incorporated vaccinations against the human papilloma virus as part of their national vaccination programmes.
As from February 2014, South Africa will become the first African country to fund cervical cancer vaccines for schoolgirls.
Dr Thandi Mtsi, a local gynaecologist and obstetrician, says that cervical cancer is not something “that happens to other women only” and notes that as many as 80% of women will be exposed to HPV in their lifetime.
Dr Mtsi adds that in South Africa more women die of cervical cancer than any other type of cancer but with the aid of regular screenings like a yearly Pap smear and timeous vaccination against HPV, cervical cancer is becoming a preventable disease.
The vaccination is 100% effective against persistent infection. It is best to be vaccinated before becoming sexually active and it is recommended that girls as young as 11 and 12 get vaccinated. However, it is never too late to get the injection, even though you may have come into contact with some of the HPV strains.
“The gold standard these days is the HPV test which checks for the virus that can cause these cell changes on the cervix. It may be used to screen for cervical cancer together with the Pap test and may also be used to provide more information when the results of a Pap smear are unclear. The HPV test is unfortunately not
yet widely available and also costly,” explains Dr Mtsi.
“People tend to shy away from discussing HPV because it is a sexually transmitted disease. While most HPV infections can be successfully treated, people’s immune systems weaken, as they get older rendering the HPV infection more dangerous and powerful. Even for women with only one sexual partner, the cumulative risk of acquiring a cervical HPV infection three years after their first sexual encounter stands at a staggering 46%.
“People need to understand that the HPV causes cervical cancer and that there is no shame in discussing it openly. If people can talk about HIV/Aids, they should be able to talk about cervical cancer and the HPV that causes it,” says Dr Mtsi.
What is the HPV?
The human papilloma virus (HPV) is a double-stranded DNA virus.
Up to 80 % of sexually active women will acquire an HPV infection in their lifetime, with the risk of persistence increasing with age.
Approximately 100 types of the HPV have been identified to date and, of these, nearly 15 virus types are considered to cause cervical cancer.
The high-risk virus types 16, 18, 45 and 31 are responsible for almost 80% of cervical cancers globally.
“If you can protect yourself from getting an HPV infection, your changes of developing cervical cancer is miniscule,” says Dr Mtsi.
How is the HPV transmitted?
The virus is transmitted through sexual contact and in rare cases from a mother to her newborn baby, explains Dr Mtsi.
The virus is not carried by bodily fluids, but rather through contact which means that safe sex will not guarantee that you will not contract the virus.
What is the link between the HPV and cervical cancer?
The high-risk HPV virus types are responsible for virtually all cervical cancer, which is cancer of the cervix.
The more a woman comes into contact with the HPV, the greater her chances are of developing cervical cancer.
“When your cervix is scarred from frequent infection, your cervical cells multiply to heal themselves. However, abnormal cells can multiply out of control as a result of the HPV infection and can cause pre-cancerous cervical lesions, which ultimately cause cervical cancer,” explains Dr Mtsi.
What are the symptoms of cervical cancer?
According to Dr Mtsi there are no early symptoms for cervical cancer.
“The first symptoms only appear when the disease progresses. Women should, however, look out for pain during sex, any change in their menstrual periods, an increased vaginal discharge and any abnormal vaginal bleeding,” she advises.
