Cervical cancer most common among women in Nagaland

DIMAPUR — Cervical cancer is the leading cancer among women in Nagaland, surpassing breast cancer even as the state continues to lag behind when it comes to awareness about this largely preventable disease.

According to data available, of the 10 leading cancer sites in Nagaland among females from 2012 to 2016, cervix tops the list (16.3%), followed by breast (12.2%) and stomach (11.3%).

“Cervical cancer screening is still low in the state mainly because Naga women are ‘very shy’ to share their medical history and it is quite challenging to convince them,” said Dr. Vinotsole (Tina) Khamo, principal investigator of the Population-Based Cancer Registry (PBCR).

Consultant gynaecologist and proprietor of Dr. Belho’s Clinic and Children’s Hospital, Dimapur, Dr. Mhasiseno T Belho also echoed similar view.

However, there was an incessant flow of patients at Dr Belho’s Clinic during the three-day free cervical cancer screening camp, organised by PBCR and Nagaland Institute of Science and Technology in collaboration with Dr Belho’s Clinic, which commenced on Aug. 21.

The screening camp, originally scheduled for two days, was extended by another day till Aug. 23, due to encouraging response. A total of 96 women turned up for the screening.

Poor awareness, misconceptions contributing factors 

Speaking to Eastern Mirror on the second day of the hectic screening camp, Dr. Khamo said that fear of undergoing the reportedly painful procedure was also another factor that keeps women away from screening.

Lamenting on the poor awareness of cervical cancer and limited screening programmes in the state, she advocated for programmes to encourage widespread vaccination and also to address misconceptions.

On the level of awareness about cervical cancer both in urban and rural areas, Dr. Mhasiseno T Belho said that, “wherever there is lack of education there is less information and awareness of cervical cancer.”

According to Dr. Belho, health centres are accessible in every district and they can assist the women groups to sensitise the people in rural areas; even the Church and educational institutions can play a big role as they can organise sensitisation programmes better.

Increasing public education through community outreach and media campaigns is essential for raising awareness about cervical cancer, its risks, and preventive measures, she said. She also emphasised that such campaigns should be at all levels and a continuing effort and not just a day or two programme.

“Human Papilloma Virus (HPV) is self-emitting and an HPV infection is a necessary, but not sufficient, cause for cervical cancer as it comes and goes like flu. However HPV 16 and 18 are two strains of HPV that are associated with cervical cancer and if they progress, it can lead to cancer,” she explained.

On the affordability of the HPV vaccine which many find it expensive, the consultant gynaecologist however is of the view that it is better to get vaccinated by spending some extra money instead of undergoing cervical cancer treatment, which is more expensive.  

Dr. Belho expounded that the risk factors associated with cervical cancer come down to lifestyle, which include early initiation to sexual activity, multiple sexual partners and smoking; while in some cases, it is genetic.

Further, it is not easy to detect cervical cancer as there are no symptoms in precancerous conditions unless one goes for regular screening for cervical cancer.

Recognising symptoms and seeking medical advice to address any concern is a critical step and women should see healthcare professionals if there is increased or foul-smelling vaginal discharge and unusual bleeding between periods, which are the common symptoms among the others.

Females over the age of 18 years should get screened for cervical cancer, she added.

Screening, vaccination crucial preventive measures

Regular screening to identify precancerous lesion when they are most treatable and vaccination against HPV are crucial preventive measures. The HPV vaccine protects against the most common high-risk strains and reduces the likelihood of cervical cancer development, Dr. Khamo said.

She reiterated that encouraging widespread vaccination and addressing its safety and effectiveness are essential towards prevention efforts. Combating cervical cancer in the state requires a multifaceted approach as treatment against the cancer is not available in all the hospitals in the state.

The principal investigator also advocated for the integration of HPV vaccination into routine immunisation programmes since cervical cancer is highly preventable if one is vaccinated in the early stages.

“Reducing costs through government subsidies and public health programmes can make vaccines more accessible as many people do not opt for HPV vaccine because of the cost since some find the dose expensive,” she shared.

According to Dr. Belho, cervical cancer remains a significant health concern for women in Nagaland and this underscores the importance of prevention strategies.

“Understanding the risk factors, vaccination options, screening practices and treatment of precancerous conditions is crucial in the fight against this preventable disease. Early stage detection is easily treatable while later stage becomes palliative action,” she said.  

Additionally, strengthening screening programmes by making them accessible and affordable is critical for early detection, she added.