Cervical cancer awareness month is here
Cervical cancer awareness month comes around every January, and this year is no different.
The reproductive health centre at Korle Bu Teaching Hospital, in conjunction with Telecel Ghana, held an official campaign launch and seminar on the theme: Protect Her Future: Prevent Cervical Cancer Now.
This programme was live-streamed on most of the media networks and featured such erudite speakers as Prof. Kwaku Asah-Opoku, who delved into the topic “HPV vaccination: understanding the scope, dispelling the myths”.
Dr James Neequaye went to town on the topic “HPV vaccination to screening: The continuum of cervical cancer prevention”. The programme was ably chaired by Prof. Samuel Antwi-Oppong.
In the spirit of the cervical cancer awareness month campaign, I dedicate the next few weeks to discussing what cervical cancer is and why we must all bring our acts together to prevent it.
The cervix is the four-centimetre-long, bottleneck-like end of the womb, which projects into the vagina, where it bridges the womb and the vagina. It has a canal contiguous with the cavity of the womb. Cervical cancer occurs when the cells of the surface of the cervix begin to grow abnormally and invade other organs or structures in the body.
Fortunately, cervical cancer takes time to develop, progressing from normal cervical tissue to the precancerous stage to invasive cancer. This slow progression through numerous precancerous changes provides opportunities for prevention, early detection and treatment.
Cervical cancer begins with abnormal changes in the cervix. Risk factors for this condition include infection with human papillomavirus (HPV), the principal cause of most cervical cancers.
Other known risk factors include early sexual contact, multiple sexual partners, cigarette smoking, HIV infection, a weakened or lowered immune system and the use of oral contraceptives. It is worth noting that the use of intrauterine devices as a birth control measure is not a risk factor for cervical cancer.
Human papillomavirus (HPV) is a virus whose different types cause skin warts, genital warts and other abnormal skin and body surface disorders. Infection with this virus has been shown to induce many of the changes in the cells of the cervix that may eventually lead to cancer. Because HPV can be transmitted by sexual contact, early sexual contact and having multiple sexual partners have been identified as risk factors for the development of cervical lesions that may lead to cancer.
Not all HPV infections lead to cancer in the majority of cases. Genital infections with HPVs typically cause no symptoms and go away on their own. Sometimes, however, the infection persists. Precancerous changes or ultimately cervical cancer only arise when there is a persistent infection by one of the HPV types associated with cervical and other cancers.
Cigarette smoking is another risk factor for the development of cervical cancer. The chemicals in cigarette smoke interact with the cells of the cervix, causing precancerous changes that may, over time, progress to cancer. Oral contraceptives may increase the risk for cervical cancer, especially when used for longer than five years.
Weakened immune systems caused by HIV infection or other causes increase the risk for cervical cancer. Other factors that have been associated with an increased risk of cervical cancer include poverty, having three or more term pregnancies and having a first pregnancy before the age of 17. Also known to increase the risk is a family history of cervical cancer.
As in many cancers, there may be no signs or symptoms of cervical cancer until it has progressed to advanced stages. The most common symptom is abnormal vaginal bleeding other than during menstruation. Abnormal vaginal discharge may also occur with cervical cancer. Cervical cancer does not usually cause pain, although it may in very advanced stages.
A bit about the bleeding, though, because vaginal bleeding can be caused by a diverse array of conditions, ranging in seriousness and varying based on the age, fertility and medical history of the patient.
Vaginal bleeding after menopause is NEVER normal and must always be investigated. Very heavy bleeding during a woman's period or frequent bleeding between periods warrants medical evaluation.
Bleeding after intercourse should also warrant a visit to the gynaecologist for evaluation. If a woman has vaginal bleeding that is associated with weakness or feeling faint or lightheaded, or if a woman faints, she should go to a hospital emergency department for care.
As with all cancers, early diagnosis is key to successful treatment and cure. Treating precancerous changes that affect only the surface of a small part of the cervix is much more likely to be successful than treating invasive cancer that affects a large portion of the cervix and has spread to other tissues.
The most important progress that has been made in the early detection of cervical cancer is the widespread use of the Papanicolaou test (Pap smear), which is done as part of a regular pelvic examination.
Named after the pathologist who developed the test, the Pap smear is a quick, painless and relatively inexpensive way of screening women for precancerous or cancerous changes in their cervix. Cells from the surface of the cervix are collected on a slide and examined. Any abnormality found on a Pap smear mandates further evaluation. It is recommended that women undergo a Pap smear every three years, beginning at 21 years of age.
To be continued next week
The writer is a member of the Paediatric Society of Ghana and the Director of Medical Affairs, Korle Bu Teaching Hospital
