Beyond period problems: Subtle symptoms that could signal cervical cancer

Cervical cancer is the fourth most common cancer in women worldwide. It is one of the most preventable and treatable forms of cancer, yet it remains one of the most common causes of death for women (IGCS -International Gynaecologic Cancer Society).The cervix is the lower and narrow part of the uterus, which connects the body of the uterus to the vagina.Cervical cancer is an abnormal growth of cervical cells. It is caused almost entirely by HPV (Human Papilloma Virus). HPV types 16 and 18 are the commonly involved types in invasive cancer (more than 75%). High-risk types of HPV can lead to early cervical changes, which, over time, can lead to cervical cancer. Early detection can be done by screening, by doing HPV testing and Papanicolaou (Pap) smears. HPV testing identifies exposure to high-risk and low-risk types of HPV, whereas Pap smears will detect early and late cell changes.Cervical cancer is a preventable disease. Screening and primary prevention are very effective modalities for decreasing the incidence and death due to cervical cancer.Although HPV testing is not recommended in women younger than 30 years, low-risk younger women should begin screening with Pap tests at age 21 and continue until age 65, per the United States Preventive Services Task Force (USPSTF) recommendations. Newer recommendations offer 3 to 5 year intervals between screenings based on a patient's prior results and the use of Pap and HPV testing.Risk factors for HPV and cervical cancer include multiple sexual partners, young age at sexual initiation, herpes simplex, high parity, HIV, coinfection with other genital infections, smoking, and oral contraceptive use.History taking is very important in cervical cancer. Any history of sexually transmitted diseases, multiple sexual partners, high risk behaviour should be asked. The history of tobacco use and prior HPV vaccination should be taken.Cervical cancer is largely preventable through HPV vaccination and regular screening, as recommended by national guidelines, and it can be cured if detected early and treated promptly.Cervical cancer is the fourth most common cancer in women globally, with around 660 000 new cases and around 350 000 deaths in 2022.The highest rates of cervical cancer incidence and mortality are in low- and middle-income countries. This reflects major inequities driven by a lack of access to national HPV vaccination, cervical screening, and treatment services, and social and economic determinants.Cervical cancer is caused by persistent infection with human papillomavirus (HPV). Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV.Countries worldwide are accelerating efforts to eliminate cervical cancer, guided by the global 90–70–90 targets: 90% of girls fully vaccinated with the HPV vaccine by age 15, 70% of women screened by ages 35 and 45, and 90% of women with pre-cancer or invasive cancer receiving appropriate treatment.17 November is observed as World Cervical Cancer Elimination Day.Bleeding after sexPostmenopausal bleedingBleeding after the periods are over (intermenstrual bleeding)Premenstrual spottingHeavy periods or longer periodsFoul-smelling dischargeCopious dischargeDischarge mixed with bloodDischarge that is recurrent and not cured by routine medicationsDischarge after menopausePain after intercoursePain in the pelvic regionDull aching lower back pain All these symptoms are commonly seen with non-cancer causes.Every woman should be educated about this and should not cause panic. She should be aware of her body and should be aware of what is normal for her.So a minimal vaginal discharge, non-foul smelling and asymptomatic, before menses can be normal for many women but if there is a change in color, odor, quantity, she should report to the hospital. What is normal for one woman can be abnormal for another. Hence, the importance of knowing your body.Cervical cancer is asymptomatic in early stages, so screening becomes very important. Pap smear is a very important screening test for cervical cancer in the early stages. Safe sex practices are vital for the prevention of cervical cancer.