Gynecological Awareness Month

Nearly two decades ago, experts discovered a relationship between infection with HPV (human papillomavirus) and cervical cancer.

In the first of a two part series we will discuss what every woman and girl should know about HPV and cervical cancer.

Cervical cancer is one of the most commonly diagnosed cancers in women in the Caribbean and one of the leading causes of death from cancer in women in the region. Often these women are in the prime of their lives with families to take care of. The question can however be asked, are many of these deaths needless?

Almost 100 per cent of all cases of cervical cancer can be attributed to one cause – exposure to a sexually transmitted form of the human papilloma virus (HPV). Most people who have ever experienced intimate sexual contact with another person will have been exposed to this virus and will have had an “active” HPV infection at some point in their lives. For most people the body’s immune system kicks into action and the infection is eliminated from the body often without the infected person ever knowing they had the virus. In a few people, sometimes because their immune system is otherwise compromised, the virus persists and remains. It is in persons with persistent HPV infections that cancer can develop, often 10 – 20 years after the initial infection.

The risk factors for cervical cancer are therefore similar to the risk factors for HPV – early age of sexual exploration and intimate sexual contact, multiple sexual partners over a lifetime especially if those partners have also had multiple partners.

The more times a woman has been pregnant the more likely she is to develop cervical cancer especially if more than one man is the father of her children. Additionally women who smoke are twice as likely to develop the disease as are women who have had a mother or sister diagnosed with cervical cancer. Long-term use of the oral contraceptive pill will also increase risk.

How to lower your risk for Cervical Cancer

Women can therefore substantially lower their risk by abstaining from initial sexual contact for as long as possible, remaining in a monogamous relationship and avoiding tobacco products. Women can also lower their risk by having a pap smear on a regular basis – at least once every two – three years or more frequently if recommended by a doctor and by getting vaccinated with the HPV vaccines; either Gardasil or Cervarix (this ideally should be done before sexual initiation). This will be further discussed in a future article.

The cells on the surface of the cervix can become abnormal before they become malignant (cancerous), a condition known as cervical dysplasia. A pap smear can identify these changes allowing treatment to occur at a stage before cancer has developed.

Should cervical cancer develop, it often does so without any early warning signs or symptoms. As the disease progresses signs that you might notice are abnormal bleeding e.g. between periods or after sexual intercourse, or for those people who no longer have a period, there may be new bleeding. You may also observe an abnormal discharge that might have an odour associated with it. Symptoms that you might feel are discomfort during intercourse and pelvic pain. It is important to remember that these are also signs and symptoms of other medical conditions, so consult your doctor if you notice any of them.

For more information on cervical cancer or HPV contact the Cayman Islands Cancer Society at 949-7618 or email victoria@cics.ky.