Know How HPV, Sexual Health, And Cervical Cancer Are Closely Linked

Cervical cancer remains a significant health concern for women. According to the International Agency for Research on Cancer (IARC), it was the second most common cancer among women in 2022 in India, with 127,526 cases, accounting for 17.7% of all cancers affecting women. It was also the third leading cause of cancer-related deaths in women, with 79,906 fatalities reported that year. It is common in women in the middle age group aged 35 to 50.

Cervical cancer is a preventable type of cancer that originates in the cervix, the lower part of the uterus that opens into the vagina. It develops when abnormal cells in the cervix grow uncontrollably and, in some cases, spread to surrounding tissues or other body parts.

The primary cause of cervical cancer is persistent infection with certain high-risk types of human papillomavirus (HPV), a virus commonly spread through sexual contact. While the immune system clears the majority of HPV infections without causing harm, some high-risk strains can lead to changes in the cervical cells over time. These cellular changes, if not detected and treated early, can progress to precancerous lesions and eventually to cancer.

Not all types of HPVs are harmful. Among over 200 identified strains, only 14 are considered high-risk, with the potential to cause cancers such as cervical cancer. Low-risk strains are associated with conditions like genital warts, but they do not lead to cancer. High risk HPV initially leads to pre-cancerous changes, which may gradually progress cancer in about 10 to 15. Precancerous changes can be detected through Pap smear or HPV tests. But if they are left untreated, they can progress to cervical cancer.

Impact of Early Detection on Cervical Cancer Outcomes

Early detection and timely treatment of cervical cancer are crucial for improving survival outcomes.  When detected in its early stages, the disease can often be treated with less invasive methods, such as brachytherapy, which not only effectively targets the tumor but also preserves fertility in many cases. This is particularly important for younger women who wish to retain their reproductive health. Early-stage diagnosis allows for a broader range of treatment options, leading to better overall survival and a higher quality of life compared to more advanced stages.

Key Risk Factors Contributing to the Development of Cervical Cancer

• Early onset of sexual activity: Starting sexual activity at a young age increases the likelihood of contracting the HPV virus and developing cervical cancer. This prolonged exposure to the virus can lead to cellular changes in the cervix, raising the risk of developing cervical cancer if not detected and treated early.
• Multiple sexual partners: Having multiple sexual partners increases the risk of HPV exposure, as any of the partner may be harbouring the virus. This raises the likelihood of persistent infections, which can lead to cervical cancer over time.
• Poor personal hygiene: Lack of proper menstrual and genital hygiene, especially in rural areas where access to sanitary products is limited, can increase susceptibility to infections like HPV.
• Young age at marriage: Women who marry young (16-18 years) are at increased risk of cervical changes due to early sexual activity. By their 30s, they may develop pre-malignant lesions or early cervical cancer.
• Repeated pregnancies: Multiple pregnancies can elevate the risk of cervical cancer due to hormonal fluctuations and the physical stress they place on the cervix, making it more susceptible to infection and abnormal cell growth.
• Long-term contraceptive use: Prolonged use of oral contraceptives can alter hormone levels, which may affect the cervix’s resistance to HPV infection, increasing the risk of persistent HPV infections that can lead to cervical cancer.
• Smoking: Smoking weakens the immune system, making it harder for the body to clear HPV infections, thus increasing the risk of cervical cancer.

Know how new treatment has improved outcomes for cervical cancer patients

New treatment approaches have led to significant improvements in cervical cancer outcomes. Advances in radiation techniques, especially image-guided therapy, have enhanced the precision of treatment. Previously, radiation planning was based on bony anatomy, but now CT-based planning allows for better delineation of the tumor and nearby organs. This ensures that the tumor receives the appropriate dose of radiation while minimizing damage to surrounding tissues, such as the urinary bladder, rectum, and intestines. As a result, treatment plans are much more effective, with fewer late side effects compared to radiation methods used 10-15 years ago.

When it comes to fertility, radiation therapy can impact the ovaries, which are located near the tumor. In cases where only brachytherapy (internal radiation) is used, fertility can be spared, but once external beam radiation is required, preserving fertility becomes more difficult due to the proximity of the ovaries to the tumor. Fertility-sparing surgeries are available for young women with early-stage cervical cancer who wish to retain fertility, but do not require radiation treatment. This highlights the importance of detecting cervical cancer in its early stages to allow for fertility-preserving treatments.

Overall, with the evolution of these treatment techniques, radiation therapy plans are more effective, side effects are reduced, and fertility-sparing options are available for early-stage patients. These improvements have positively impacted patient outcomes and quality of life.

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