Cervical Cancer: females let’s get vaccinated!!

Sep 30, 2014 Ruchira Dhoke Lifestyle & Health 0

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Cervical Cancer is the only cancer which can be prevented!! 

It was not too long ago, as late as the 1940s, that cervical cancer was a major killer of women of childbearing years. Worldwide, cervical cancer is the second most common type of cancer in women. Fortunately in the U.S., the introduction of cervical cancer screening by the Pap test led to a 74% decrease in the incidence of cervical cancer from 1955 to 1992.

What is Cervical Cancer?

It is a cancer of the epithelial tissue of the cervix. Cervical cancer forms in the interior lining of the cervix, the junction of the vagina and uterus. The development of cervical cancer is typically slow, and occurs over a period of years. Cervical cancer is most often diagnosed in middle-aged women, with half of those diagnosed between the ages of 35 and 55.

Human papillomavirus (HPV) infection is the major risk factor for development of cervical cancer.

Human Papillomavirus (HPV)

Human Papillomavirus (HPV) is a dsDNA oncogenic virus belonging to Papovavirus family. It causes common warts, sexually transmitted venereal warts, and tumors of the respiratory, intestinal and genital tracts.

The association of HPV with cervical neoplasia has been established by various studies. Although HPV provides the major risk, other factors appearing to be necessary for the development of cancer are: smoking, multiple sexual partners, first sexual intercourse at a young age, using oral contraceptives (“the Pill”), immunodeficiency, and infections like genital herpes or chronic Chlamydia.

Rather than a dramatic shift from normal to neoplastic epithelium in the cervix, there is a continuous spectrum, recognized as increasingly severe grade of cervical intraepithelial neoplasia. The final stage is the process in the development of overt malignancy, invasive carcinoma which may be either glandular or squamous.

There is a continuum in the expression of HPV genes and antigens. As the cervical epithelial changes progresses from mildly dysplastic to severely dysplastic a characteristic perenuclear clearing is seen in the squamous epithelium accompanied by nuclear atypia. Although this appearance might not be present in all HPV-infected cells.

Types of Cervical Cancer

The two types of cervical cancer are squamous cell carcinoma and adenocarcinoma, which are distinguished based on their appearance under a microscope. Both squamous cell and adenocarcinoma begin in the cells that line hollow organs, but squamous cells have a thin, flat appearance while adenocarcinomas involve cells with secretory functions. Squamous cell carcinoma is far more common and makes up approximately 90% of cervical carcinoma cases. Both types have similar risk factors, prognoses and treatments.

Symptoms of cervical cancer

Most often, cervical cancer in its earliest and most treatable stages does not cause any symptoms. When there are symptoms, the most common are persistent vaginal bleeding, abnormal vaginal bleeding especially between menstrual periods, after intercourse and after menopause. Advanced cervical cancer may cause symptoms like loss of appetite, weight loss, fatigue, pelvic back pain, or leg pain, leaking of urine or feces from the vagina.

The major breakthrough…… Quadrivalent HPV Vaccine for Cervical cancer

 “Prevention is better than cure”…such a cliché, but it is true. Everybody wants to plan their future well and why not but the plans should certainly include protection against cervical cancer.

HPV vaccine represents an important opportunity to significantly reduce the global burden of cervical cancer.  With more than 80% of cervical cancer cases affecting women in the developing world, the burden of this preventable disease disproportionately affects women in countries where cervical cancer screening and treatment systems are weak or non-existent.

Cervical cancer is caused by persistent infection with oncogenic types of the human papillomavirus (HPV). Two HPV vaccines have been developed that protect women against the two types of HPV (16 and 18) responsible for 70% of cervical cancer cases worldwide.  Since 2006, Merck’s HPV vaccine, Gardasil® and GlaxoSmithKline’s HPV vaccine, Cervarix®, have been licensed in over 100 countries worldwide. FDA approved the Vaccine in 2006.

Dosage:series of three injections over a six-month period. The second dose is given one to two months after the first dose, and the third dose is given six months after the first dose.

Efficacy: Clinical trials found that both vaccines are at least 95% effective in preventing HPV-16 or -18 persistent infections and at least 93% effective in preventing vaccine type-specific cervical lesions when given to girls prior to sexual activity, or to women without prior infection with these HPV types.

WHO Recommendations

The World Health Organization recommends that routine HPV vaccination be included in national immunization programs based on the following key considerations:

1. Prevention of cervical cancer or other HPV-related diseases, or both, constitutes a public health priority;
2. Vaccine introduction is programmatically feasible;
3. Sustainable financing can be secured;
4. The cost-effectiveness of vaccination strategies in the country or region is considered; and
5. HPV vaccination is targeted to adolescent girls prior to sexual debut.

The major goal of immunization against human papillomavirus (HPV) infection is to reduce the incidence of anogenital cancer, which vaccination can achieve by inducing immunity against the “high-risk” genotypes of HPV, thereby preventing persistent infection.

Widespread use of HPV vaccine alone has the potential to reduce cervical cancer deaths by 50% over several decades depending on immunization coverage and additional cross-protection against certain types of HPV.

Developing strategies to effectively reach adolescent girls with HPV vaccines — a population not typically the focus of public health programs — is essential to achieving high coverage rates and reducing the cervical cancer burden.

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• Cervical cancer, Women health

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