Skip to main content
Submitted by CD on 6 March 2016

Yes. Almost 70% of cervical cancers can be prevented by it, says obstetrician and gynaecologist Dr Chandan Dubey, and strongly advocates that the HPV vaccine be made part of the national immunization programme. 

What does screening for cervical cancer involve?

Cervical cancer is the most easily preventable gynaecologic cancer because cervix is so accessible to screening.

Cervical cancer screening involves 2 tests:

  1. Pap smear or liquid based cytology (LBC): This test involves looking for changes in cells from cervix which could progress to cancer if not detected and treated if necessary.
  2. HPV DNA  test: This test is to detect certain HPV (Human Papillomavirus) viruses which can cause these changes.

Women should have a pap test or LBC every 3 years starting from age 21 years up to 65 years. After 30 years of age combined Pap test and HPV virus testing is recommended and then needs to be repeated only every 5 years till the age of 65 years.

A cervical screening requires a woman to lie down on an examination table or couch on her back. She is asked to draw up her knees and take them apart. A metal or plastic instrument called a speculum is inserted gently into the vagina by the doctor and the cervix is inspected under good light. Cervix is the opening of the uterus or womb. A brush is gently rubbed on the cervix and the cells deposited on the brush are transferred to a liquid which is sent for cytology testing.

HPV DNA may be tested with a swab from the cervix or the same specimen may be used. A pelvic examination may be done at the same time, where the gynaecologist feels for the uterus, tubes and ovaries.

The test result if normal will need to be repeated as per local screening protocol. Around 5% women may have some abnormal cells and will need to have HPV virus testing if mild abnormality is present. 

If HPV test is positive or abnormality is of a higher grade then a test called colposcopy is done. Cervix is viewed under magnification with a telescope and biopsy taken as needed.

Do you send screening reminder to all your eligible patients?

Cervical cancer screening needs to ideally include all women of the recommended age group. This needs the regional health service delivery systems of a particular area to be involved. Formal screening programmes are developed by some countries to cater to the eligible women who need to be covered.

At what stage do most patients with cervical cancer come to you for their first visit/diagnosis?

In all stages of cervical cancer - early and advanced.

Are you involved in any awareness programs/campaigns? 

Educating patients in my clinic who come for any problem if they are in the eligible age group and strongly recommending them for cervical screening.

What do you think should be the best way to spread awareness and education about cervical cancer screening?

In countries where there is a national screening programme for cervical cancer it is easier to spread awareness than in countries like India where spreading awareness and education about the prevention of this dreaded disease is a challenge as such programmes still do not exist. Doctors, especially gynaecologists are already involved by offering opportunistic screening to all women who present to them for any other health problem and are in the eligible age group. Health ministry, NGOs, media and health websites all need to be involved.

Related article: Cervical Cancer screening and diagnosis do not occur in the same facility leading to a loss of followup.

Have you noticed any trends regarding cervical cancer epidemiology in your practice such as an emerging risk factor, etc?

Incidence of cervical cancer seems to be on the decline as more and more women are being covered under screening. This is also reflected in international statistics in areas where formal cervical cancer screening programmes are in place.

Which HPV vaccine do you use: Gardisil or Cervarix?

Cervarix is available in the hospital where I work hence I use that. For prevention of cancer cervix all available vaccines are equally effective. Gardasil offers additional protection against genital warts.

At what age do you recommend the HPV vaccine?

HPV vaccine is recommended for 11 and 12 year old girls. It can be given up to 26 years of age for those who have missed it earlier.

If you recommend the vaccine for teenagers, what is the most common response of mothers? How do you deal with it?

Most mothers are very receptive to the idea of cervical cancer prevention vaccine and agree for it after proper counselling.

Do you recommend HPV vaccine to sexually active women?

HPV vaccine is most effective when taken before sexual activity is initiated because the exposure to HPV virus occurs only after sexual activity. It is recommended for women upto 26 years of age if they have missed it earlier, even if they are sexually active. The vaccine will still give some protection.

Have you noticed any side-effects of the vaccine?

Minor side effects like pain at injection site and occasionally dizziness for a few minutes are the possible side effects.

Do you think more females need to be aware of and take the vaccine?

Like all vaccines, the maximum benefit will be derived if the entire eligible population is covered. This will be possible only if all governments take the initiative and make HPV vaccine a part of the national immunization programme. 70% of cervical cancers can be prevented by vaccination. All HPV viruses which can cause cancer cervix are not covered by the existing vaccines hence screening is still necessary for vaccinated women also.

 

Condition

Stories

  • Image of a woman experiencing hot flashes and using a hand fan. Text overlay on blue strip - Menopause And Cancer
    Tips To Manage Menopause During Cancer Treatment
    Developing menopause while going through cancer is a double whammy for all women. The sudden jolt of menopause caused by cancer treatment is not only physically but mentally straining as well.  Can physiotherapy help alleviate these distressing menopausal effects and improve quality of life for women with cancer? Ajeeta Kulkarni, a senior physiotherapist at Tata Memorial hospital in Mumbai, tells us how. What are the causes of menopause in cancer patients? Menopause is the decline in the…
  • A partially visible person in white top and pants holding the urge to urinate with text on blue strip How to manage incontinence
    Managing Bowel and Bladder Incontinence in Cancer Patients
    Bowel (fecal) and bladder (urinary) incontinence is a relatively common side-effect that can occur during cancer treatment. Due to the stigma and under-recognition attached to this condition, quality of life suffers significantly in persons with cancer. Learn more about managing this condition with Prachi P. Narkhede, a MPT Cardiovascular & Respiratory Physiotherapist at Tata Memorial Hospital. What is incontinence? It is loss of control of bladder and bowel causing accidental leakage of…
  • Profile pic of cervical cancer survivor in a teal, white and blue frame with the logo of PatientsEngage
    We Must Alert Others About Prevention of Cervical Cancer
    Poonam Kamdar, a counseling psychologist, had stage 2 cervical cancer. Because of her traumatic journey, she now fiercely advocates for the human papillomavirus (HPV) vaccine which can help protect against cervical cancer and encourages women to speak openly about their experience. Diagnosis Which year and at what age were you diagnosed with cervical cancer? I was diagnosed with cervical cancer in the year 2015, at age 45. What were the early warning signs and symptoms that made you sense…
  • A woman, a cancer survivor of cervical and colorectal cancers sitting on a sofa
    Ten Years After Cervical Cancer
    B V Lakshmi, a resident of USA, reflects on her decade long journey with three cancers - cervix cancer, colon cancer and rectum cancer, living with the complexities of the ileostomy bag and discovering the healing power of the mind. Read about how she embraced change and positivity. My Childhood… I grew up in India, traditionally in a vegetarian family. Both my paternal and maternal grandparents were aligned with nature and ate what nature gave them, so we were also taught the same things. I…
  • Cancer Screening Guidelines For Indian Women
    Screening for Cancer is a crucial part of Cancer Prevention and Control for women. In the second part of this guide on screening, Dr Gauravi Mishra  focusses on the screening strategies for women related cancers like Breast Cancer and Cervical Cancer.  Can you explain the difference between the various screening tools used for Breast cancer i.e. ultrasound vs BSE vs mammography vs thermography? Breast Self-Examination BSEs first started 1930s; gained more recognition in 1950s-1960s…
  • Cervical Cancer
    Cervical cancer refers to cancer that originates in the cells lining the cervix, which is the organ connecting the uterus and the vagina. There are two main types of cervical cancers: The most common is squamous cell carcinoma, arising in the squamous (flattened) epithelial cells that line the cervix. The other is adenocarcinoma, which starts in the mucus-producing gland cells of the cervix.  The human papilloma virus (HPV) infection is the leading cause of cervical cancer.…
  • Stock image of a woman in blue scarf in the foreground and a group of people in the background pointing to her
    "Its Time For Film Characters That Survive Cancer!"
    Cancer stigmas are often barriers for seeking diagnosis, as well as treatment and rehabilitation. Shubha Maudgal and Susmitra Mitra of Cancer Patients Aid Association (CPAA), Mumbai give us an insight into the current taboos surrounding cancer and the challenges such stigmas pose for patients and society. 1. What does cancer stigma entail? There are two kinds of stigma involved with cancer. One is Self which is in the mind of patients themselves, stemming from guilt or shame.  The other is…
  • image of a stethoscope and a gloved hand holding a bottle marked hpv vaccine
    Guard Yourself from HPV-related Warts and Cancers
    Dr Gayatri Deshpande, senior gynaecologist, cautions against infection of the Human papillomavirus (HPV) transmitted mainly through sexual contact that can cause painful and highly contagious genital warts resulting in a range of cancers in both men and women and advises safe sex to reduce risks. What is Human Papillomavirus (HPV) infection and how do you get it? This is an infection caused by Human Papillomavirus which is a DNA virus. One can catch this infection by sexual contacts which may…
  • Dr. Sarita Bhalerao speaking at the CPAA UICC Cervical Cancer symposium
    India has 1 in 4 of Global Cervical Cancer Cases
    On World Cancer Day, CPAA along with UICC held a mini symposium to address the 2nd most common cancer in India; Cervical Cancer. Keynote speaker, Dr Sarita Bhalerao (Gynaecologist & Obstetrician) provided a comprehensive view of Cervical Cancer. Dr Suresh Advani (Medical Oncologist) graced the occasion commencing the ceremony with good news about Cervical Cancer. Decreased incidence rates reported in India and globally. 60% survival rate with treatment. Increased screening and prevention…
  • The Best Tips Come From Cancer Patients and Survivors
    The Best Tips Come From People Who Have Beaten Cancer
    This World Cancer Day, cancer survivors and PatientsEngage contributors share advice based on their lives experience on how best to deal with a cancer diagnosis. #WeCanICan #WorldCancerDay #WCD2018 What would you tell a person who just learned of their cancer diagnosis?’ 1. Dilip Kumar Mevada, Multiple myeloma survivor Cancer so what? You can overcome it. You have to accept and forgive that you have cancer.  If I can survive you can also survive. We are the luckiest human beings to have…