In the last couple of days, cervical cancer has made headlines but not for the right reasons. From what began with Finance Minister Nirmala Sitharaman’s promising announcement on the government’s plan to encourage HPV vaccination for cervical cancer prevention, the conversation veered to voyeurism.
The drama that unfolded with Poonam Pandey’s controversial tactics to draw attention on the matter has become a subject of ethical debate. The whole fiasco on Poonam Pandey’s supposed death to “raise awareness” of cervical cancer has highlighted the lack of awareness about this disease.
As the Netizens began their discourse on Poonam Pandey’s “publicity stunt”, the conversation also began drifting to how cervical cancer reflects a “state of moral and cultural decline” or how the cancer is prevalent among promiscuous women.
Several doctors on various social media platforms like X (erstwhile Twitter) came forward to debunk the misinformation and opined that stigmatising diseases like cervical cancer can have negative implications on the timely diagnosis and treatment of this disease.
According to the World Health Organization (WHO), cervical cancer is the fourth most common cancer in women. Cancer is a disease that occurs when there is an uncontrollable growth in some of the body’s cells and when this happens in the cervix, it is called cervical cancer.
The Centers of Disease Control and Prevention (CDC) maintains that long-lasting infection with certain types of human papillomavirus (HPV) is the main cause of cervical cancer. It is noteworthy that HPV is a common virus that is passed from one person to another during sex.
According to the CDC, at least half of sexually active people will have HPV at some point in their lives, but few will get cervical cancer.
“Cervical cancer is a significant public health issue in India, with a high prevalence rate. In 2022, India registered 1,23,907 Cervical Cancer cases and 77,348 deaths. That’s a large number of cases. After Breast Cancer, Cervical Cancer is the second-most frequent malignancy affecting middle-aged women in India. According to the World Health Organization (WHO), India accounts for a disproportionate burden of cervical cancer cases worldwide, contributing to approximately 25 percent of the global cervical cancer burden,” Dr. Suhail Qureshi, Senior Consultant & Unit Head – Medical Oncology, Fortis Hospital, Shalimar Bagh told Financial Express.com.
‘Not all HPV infections lead to cervical cancer’
When a person is diagnosed with cervical cancer, they face a multitude of challenges which include social and emotional hurdles. As cervical cancer is laced with stereotypes and stigma, people tend to feel shame in coming forward which can, consequently, delay timely diagnosis and treatment. According to WHO, cervical cancer can be cured if diagnosed and treated at an early stage of disease.
“Stigma and lack of awareness regarding any cancer are major impediments in their early detection and treatment. This applies to Cervical cancer as well. Due to cultural and social taboos surrounding reproductive health and sexuality, discussing symptoms or seeking medical help for cervical cancer can be difficult for patients. Moreover, limited awareness about the importance of regular screenings and preventive measures leads to late-stage diagnoses and poorer outcomes,” Dr. Qureshi highlighted.
The persistent stigma and taboo and labelling of cervical cancer as a sexually transmitted disease (STD) can lead to women believing that being HPV positive can seen as a sign of infidelity and lack of sexual restraint. Similarly, misinformation can give rise to the belief that getting HPV vaccination may lead to lead to sexual promiscuity.
Dr Shefali Sardana, Principal Consultant, Max Smart Super Speciality Hospital, Saket told Financial Express.com that stigma and lack of awareness delay the diagnosis as women fear losing support from family or how they will talk about this with their husbands.
However, it is important to understand that cervical cancer is not an STD. Most women and men too contract HPV at some stage during their life. HPV is an extremely common virus just like the flu or a cold.
“Infection with Human papilloma virus or HPV is the most common sexually transmitted infection (STI). Cervical cancer is primarily caused by persistent infection with high-risk types of human papillomavirus (HPV), which is often transmitted through sexual contact. However, not all HPV infections lead to cervical cancer. Most strains of HPV are responsible for causing genital warts. These strains do not cause cancer. Chronic infection by other high-risk strains of HPV (most commonly HPV 16 & 18) can lead to Cervical cancer. Other factors, such as smoking, immunosuppression and having multiple sexual partners also play a role in the development of cervical cancer,” Dr. Qureshi explained.
Understanding the link between HPV and cervical cancer
HPV can remain dormant in the body for years, and it can also cause symptoms like genital warts or benign growths. Moreover, there are various non-sexual risk factors of cervical cancer like smoking, and weakened immunity due to diseases like cancer, organ transplant, and autoimmune conditions.
“Almost all cases of cervical cancer are caused by HPV. Acquiring HPV infection is the first step in the causation of cervical cancer. Persistent infection with high-risk HPV types, such as HPV 16 and HPV 18, can lead to cellular changes in the cervix that may progress to cervical cancer over a period of time. HPV enters the body through mucous membranes, primarily during sexual activity,” Dr. Qureshi explained.
He also emphasised that most HPV infections resolve on their own without causing any symptoms or long-term effects.
“Our body’s immunity is able to eliminate the virus on its own in most cases. However, in some cases, persistent infection with high-risk HPV types can lead to precancerous changes in cervical cells, known as cervical dysplasia. Regular cervical cancer screening, such as Pap smear tests and HPV testing, can detect these changes early, allowing for timely intervention and treatment,” he added.
‘Early diagnosis is crucial’
Cervical cancer is treatable and curable especially when diagnosed at an early stage. Treatment options for cervical cancer in India include surgery, radiation therapy, chemotherapy, targeted therapy and immunotherapy.
According to Dr. Qureshi, the choice of treatment depends on the stage of the cancer, the patient’s overall health, and other factors. “In cases of advanced or recurrent cervical cancer, treatment may focus on symptom management and improving quality of life, he added.
How to prevent cervical cancer?
Prevention strategies for cervical cancer include vaccination against HPV, regular cervical cancer screening, practising safe sex, quitting smoking, and maintaining a healthy lifestyle, Dr. Qureshi said.
“HPV vaccination is recommended for girls and boys before they become sexually active, typically between the ages of 9 and 14 years. Cervical cancer screening guidelines vary, but regular Pap tests and HPV testing are essential for early detection and prevention, he maintained.
He also said that it’s crucial for individuals to prioritize their reproductive health and seek medical attention if they experience any symptoms of cervical cancer, such as abnormal vaginal bleeding, pelvic pain, or unusual discharge.
“Early detection and timely treatment significantly improve the prognosis and long-term outcomes for cervical cancer patients. Encouraging open dialogue about cervical cancer, dispelling myths, and promoting awareness can help overcome stigma and improve access to care for affected individuals in India,” he told Financial Express.com.
Meanwhile, Dr. Sardana emphasised that creating awareness about importance of HPV vaccines will help in achieving the goal of eradicating cervical cancer from India.
