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This year's theme for International Women's Day is "Choose to Challenge". It means that a woman is an autonomous individual with all the rights and responsibilities that comes with being human. It also means that women have every right to be assertive about their wishes and aspirations. Since the dawn of human history, women have been active agents in sustaining society through her rich repository of cultural knowledge but at the same time have suffered silently due to the way society is structured to her disadvantage. One of the areas where women have faced chronic neglect is in matters related to her health. This problem is especially acute in poor resource communities; either due to financial dependency, poor access to health care, or because of the way society's power relations is set up against her welfare.
Women's health and empowerment go hand in hand. Poor health perpetuates her dependency and contributes to the standard patriarchal narrative of women as weak and inferior. True emancipation requires a healthy woman who can go about doing her business without fear of being incapacitated by illness. Good health is empowering and is therefore an essential component of her overall well-being. Women's contribution to the health and economy of the family and society is also closely linked to her physical and mental health. With the right knowledge, tools and actions she can control the way her health is cared for, making it possible for her to participate meaningfully in the society. Only a healthy woman can "Choose to Challenge".
Women encounter a lot of health risk in her lifetime: domestic violence, sexual abuses, sexually transmitted diseases, child birth related morbidities and cancer of breast and reproductive organs. One of the major diseases afflicting women is cervical cancer. It is the second most common cancer in women. About 530,000 new cases of cervical cancer are detected every year. And more than 270,000 women die of the same every year. The World Health Organisation (WHO) has made elimination of cervical cancer a goal and hopes to achieve it by the year 2030.
Cervical cancer is a preventable disease but awareness about it is limited. This article will try to provide an overview of cervical cancer, including its symptoms, causes and possible interventions to limit its incidence.
What is cervical cancer? Cervical cancer is cancer of the opening of the uterus, the cervix. It connects the vagina (or birth canal) to the uterus (womb). Cervical cancer usually starts when the cells on the cervix become abnormal and grows haphazardly (dysplasia).
What are the symptoms of cervical cancer? Cervical cancer has a long pre-cancerous stage and is often asymptomatic. Only later stage cervical cancer has symptoms and can include:
• Heavy vaginal bleeding or discharge (more than usual) • Bleeding after sex, between periods or after a pelvic exam • Pain during sex or urination
What are the risk factors for cervical cancer?
• HPV causes nearly all cases of cervical cancer. It is a common virus and is sexually transmitted. Both men and women can have HPV. • Women who smoke are about two times more likely to get cervical cancer. Cigarettes may damage the cells of the cervix, which can lead to cervical cancer.
• Women over the age of 30 are more likely to get cervical cancer. • Using birth control pills for five years or longer • Having multiple sexual partner increases risk of HPV infection.
How can I lower my chances of getting cervical cancer? The HPV vaccine protects against the types of HPV that most often cause cervical cancer. It is recommended for both males and females.
How can I get screened for Cervical Cancer? Cervical cancer can be prevented or found early with regular screening tests. There are two screening tests that can help prevent cervical cancer or find it early:
• Pap Smear and/or Visual Inspection with Acetic Acid (VIA): A Pap test looks for changes in cells taken from the cervix and looks for abnormal cells that may become cancer. In western countries death form cervical cancer has gown down drastically due early diagnosis. • High Risk HPV test: The High Risk HPV test looks for types of HPV that cause most cases of cervical cancer. A positive result for High Risk-HPV requires follow up to make sure that abnormal cells do not develop.
How often should I be screened for cervical cancer? The following screening recommendations have been developed by WHO for women at average risk for cervical cancer.
• Women should start cervical cancer screening at 21 years of age. • Women ages 21 to 29 years should have a Pap test every three years. • Women ages 30 to 65 years have the choice to get a Pap test every three years, a HR HPV test every five years, or a Pap test and HR HPV test every five years. • Women can stop getting screened if they are older than 65 and have had normal Pap results for many years.
Where can I get a cervical cancer screening? Cervical cancer screening is available in almost all Public District Hospitals and private Multi-specialty hospital offering gynecological services.
When to get vaccinated with the HPV vaccine? WHO recommends that all girls in the age-group 9-14 get vaccinated for HPV. Women in the age group 15 to 45 may also get vaccinated after consultation with their doctor.
Is the vaccine safe for pregnant women? Though studies show no effects on the baby, HPV vaccine is not recommended in pregnant women.
Dr. Mhasiseno T Belho (DNB) Consultant Gynecologist Dr. Belho’s Clinic Walford Road, Dimapur
Dr. Emmanuel L Yanthan (MS) Consultant Gynecologist Dr. Belho’s Clinic Walford Road, Dimapur