This month of January marks a new year on the calendar, a month to make resolutions for a better and healthier you. January is also designated as International Cervical Cancer Awareness Month. This is a great opportunity to make a resolution where women’s health is concerned.
In Trinidad and Tobago, cervical is the second leading cause of death due to cancer among women. The Human Papilloma Virus (HPV) is the main cause of cervical cancer. Cancer is essentially a disease in which cells in the body grow out of control and is always named for the part of the body where it starts, even if it spreads to other body parts later. When cancer starts in the cervix, it is called cervical cancer. The cervix connects the vagina (birth canal) to the upper part of the uterus (or womb). The uterus is where a baby grows when a woman is pregnant.
All women are at risk for cervical cancer, and this because HPV is a quite common and a very infectious virus. The HPV passes from one person to another during sex, which leaves a statistic of at least half of sexually active people having HPV at some point in their lives, but few women will get cervical cancer.
Almost all cervical cancers are caused by HPV, that is most often than not, contracted during sexual intercourse. There are many types of HPV. Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts. HPV is also related to oropharyngeal, anal and penile cancers
HPV usually causes no symptoms so you cannot tell that you have it. For most women, HPV will go away on its own. However, if it does not, there is a chance that over time it may cause cervical cancer.
Other things can increase your risk of cervical cancer:
Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems for example from organ transplant or long-term steroid use
Women with Polycystic Ovarian Syndrome (PCOS)
Using birth control pills for a long time (five or more years).
Having given birth to three or more children.
Having several sexual partners.
Cervical cancer was once the number one cause of cancer death among women because in its early stages it is asymptomatic. This is a key stage to identify cancer. If caught at this early stage, curative treatment is possible. There was no way to pick it up before it became symptomatic in the advanced stages, by which time curing it would have been virtually impossible and all that is left to do is to offer palliative care. Palliative care involves just treatment of the symptoms, so that the patient is comfortable for the remaining short time of their life before the cancer spread leads to death.
However, today cervical cancer is very much preventable because of the availability of a screening test that picks up the HPV infection and cervical cancer in the early asymptomatic stages, and an HPV vaccine. The most important thing you can do to help prevent cervical cancer is to have regular screening tests from 21 to 65 years, at least every three years. The screening test for cervical cancer is the Pap smear, which is one of the best screening test developed for any cancer. It is very simple, effective and sensitive in identifying not only cancer, but identify precancerous changes in the cervical cells, five to 15 years before the diagnosis of cancer. When cervical cancer cells or precursors to cancer are found this early, it is highly treatable and associated with long survival and good quality of life.
The Pap smear is a procedure used to collect cells from the cervix so that they can be looked at under the microscope to find cancer or pre-cancer cells. These cells can also be used for HPV testing. A Pap smear test can be done during a pelvic exam, but not all pelvic exams include a Pap test. An HPV test can be done on the same sample of cells collected from the Pap test. Pap smears are available by appointment at most of the over 100 health centres throughout T&T and is managed by the Population Programme Unit of the Ministry of Health. If pre-cancer cells are found via a Pap smear, patients are referred for a special test called colposcopy at the hospital to determine their status with respect to cancer and determine the appropriate treatment. Referral services for colposcopy, treatment of pre-cancer and cancer is available at all public hospitals.
Who should get a Pap smear and how often?
All women should begin Cervical Cancer testing (screening) at age 21.
Women aged 21 to 29, should have a Pap test every three years.
Women aged 30 to 65 should get tested every three years.
Women over 65 years of age who have had regular screening in the previous ten years should stop cervical cancer screening as long as they haven’t had any serious pre-cancers.
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