The cancer of Cervix (uterine mouth) is a dreadful disease. Like most cancers, it does not cause any pain while developing and thus often gets detected late. This is especially true in our country where women are not routinely screened by PAP smears – a pre-cancer screening recommended to all sexually active women after the age of 30.
Human Papilloma Virus (HPV) - is the cause of virtually all cases of cervical cancer. It is a DNA tumor virus, and there have been more than 100 types of HPV identified.
Around 15 to 18 of these types have been found to be associated with cancer. Of these high-risk HPV types, types 16 and 18 are the most important clinically, because they are associated with approximately 70% of cases of cervical cancer. (Low-risk types like HPV 6 and 11 are associated with approximately 90% - 95% of cases of genital warts).
The virus is transmitted through sexual contact. Considering the fact that it is a skin-to-skin virus rather than a body fluid virus, it is hard to completely guard the transmission of this virus. Current estimates say 80% of sexually active adults will have acquired an HPV infection some time in their life by the time that they turn 50.
The best part is that a vast majority of HPV infections will resolve on their own; this is referred to as HPV clearance. Within 2 years, approximately 80% to 90% of infections resolve completely. HPV infections which do not resolve, pose one of the major risks for developing cancer.
Secondary Prevention was the only method available to us before the vaccine against the HPV was developed. Thus PAP smears for early detection and management of pre-cancerous lesions when detected – was the only solution until recently.
Primary Prevention is through Vaccination
The Vaccine:The vaccine contains HPV Virons – (Virus like HPV Particles). Like other vaccines, they evoke an antibody reaction in the body preventing infection from setting in, in case the individual is exposed to the virus. Since HPV types 16 and 18 cause the maximum number of cases of cervical cancer, a vaccine against them could prevent upto 70% - 80% of Cervical Cancers.
Dosage: Intramuscular injection of 3 doses/0.5mL each
Recommended Age – from 9 to 26 years ideally, with extended use till 45 years.
Immunization before onset of sexual activity is ideal.
The reason for inoculating older and married women is - Women of all age groups are potentially at risk and studies have shown each year, 5-10% of women above 25 will acquire a new infection with HPV 16 or 18. Both vaccines are preventative vaccines and they don't treat the cancer once it has affected the person.
Vaccination does not mean that future screening can be skipped – because it does not protect against other strains of the virus or, sexually transmitted diseases such as HIV. So even those who have been vaccinated should still receive annual PAP smears and practice safe sex.
The vaccination has been proven to be very safe. Minor rash or pain may occur as side effects. Many countries have it now in their health programme of vaccination.
The vaccine has been approved by Indian organisations like FOGSI (Federation of Obstetricians and Gynecologists) and IPA (Indian Pediatric Association) recommends it to all those who can afford it.
Cost of the Vaccine: The total cost (3 doses) may come upto Rs 6000/ to 7000/-.
Pregnancy & vaccination - The use of the vaccine in pregnancy is not recommended
Women who become pregnant before completion of vaccination are advised to postpone the remaining dose until after the pregnancy. Lactating women can receive the HPV vaccine and still continue breastfeeding because it is a vaccine without live viral DNA.
Go for the vaccine and prevent cervical cancer! Unfortunately, it is the one of the most common cancer among women in India today, so don't forget to share this article with every woman you know. :-)
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