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Cervical cancer & its prevention by vaccination

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cervical cancer & prevention

Cervical cancer & its prevention by vaccination

Dr. Anuradha Kapur
Director & Head of Unit - Institute of Obs and Gynae
Obstetrics And Gynaecology

Cervical cancer in women is the second most common cancer worldwide, next only to breast cancer. Cervical cancer can almost always be prevented through awareness, regular screening and early treatment of abnormal cell changes.

HPV INFECTION -a virus called Genital Human Papillomavirus- can cause normal cells on your cervix to turn abnormal. Over many years, abnormal cells can turn into cancer if they are not found and treated by your doctor. Human pappiloma virus is high risk infection that can be transmitted by sexual contact and also by non penetrative sex. Good news is that 90% of new infections clear out in 2 years

PERSISTENCE OF INFECTION IS DUE TO

        • Young age at sexual initiation i.e. less than 25 years.
        • Multiple sexual partners.
        • Increased number of childbirths.
        • Not using condoms.
        • Genetic factors.
        • Smoking.
        • Oral contraceptive use.
        • Lack of circumcision of partner.

SCREENING FOR CERVICAL CANCER

            • Start pap smears for screening of cervical cancer at the age of 21 and continue every 3 years till age 30.
            • Women above 30 should get screened every five years with Pap test plus HPV DNA test.
            • If you have risk factors such as multiple sex partners, a weak immune system, are a smoker, a history of DES Exposure In Utero or HIV infection, you should continue to have a pap test every year.
            • Routine screening can discontinue if:
            • You reach age 65 and 3 Pap results have been normal in the past 10 years and you are not in the high risk group for cervical cancer.
            • If you have had a hysterectomy for benign (non-cancer) reasons.

VACCINES TO PREVENT HPV INFECTION

              • Two Vaccines are available:
              • Quadravalent Vaccine (GARDASIL) -intramuscular in upper arm.
              • Bivalent Vaccine Cervarix -intramuscular deltoid in upper arm.
              • Since it is a prophylactic vaccine, it should be given before sexual debut. It cannot treat existing HPV infection or disease thereof.
              • It is recommended between 9 to 12 years of age.
              • Catch-up vaccination can be given to females between 13 & 26 years who have not been previously vaccinated or who have not completed the full course.
              • It is important to remember that screening with pap smear has to continue even in vaccinated women.
              • Also, women who were sexually active before vaccination could already be infected, hence a pap screening is helpful.