Part 2
Prevention and treatment
Guyana has one of the highest incidences of cervical cancer in the world. Both the incidence of and mortality from cancer of the cervix are 50% higher in Guyana than the rest of the Latin American/Caribbean region. According to the WHO, there were 500,000 new cases of cervical cancer in 2005 world wide. The key to controlling this disease lies in prevention.
Human papilloma virus (HPV)
HPV infection has been detected in up to 99% of women with the common type of cancer of the cervix (squamous cell carcinoma). This virus has many subtypes. There are thirteen high-risk HPV subtypes, two of which – Types 16 and 18 – are found up to 62% of cervical cancers. HPV infection like other viral infections such as chickenpox can be prevented by immunization, however treatment, once infection has occurred, is difficult if not impossible.
Cancer vaccine
Looking at these figures it is obvious that if HPV infection can be prevented, it will impact on the incidence of cancer of the cervix. Thus, the first vaccine ever designed to prevent a cancer, the HPV vaccine was launched in 2006.
How does the cervical cancer vaccine work?
The vaccine specifically blocks four high-risk HPV types which cause 70% of cervical cancers and 90% of genital warts, and therefore prevents infection from these types of viruses.
When should the cervical cancer vaccine be given?
It is recommended for girls aged 11 to 12 and may be used in girls as young as nine. This allows a girl’s immune system to be activated before she is likely to encounter HPV.
Vaccinating at this age allows for the highest antibody levels to develop.
Recommended dose
The vaccine is given as a series of three injections over a six-month period. The second dose is given two months after the first dose, followed four months later by the third dose.
A catch-up immunization is recommended for girls and women aged 13 to 26 who have not been vaccinated or who have not completed the full vaccine series.
Should you have the vaccine if you are already sexually active?
It has been found that the vaccine effectively reduced disease in a group of sexually active women aged 26 or younger, even though they had already been infected with one or more of the types of HPV that the vaccine is designed to fight; therefore, even if you are already sexually active, you should have the vaccine.
What does the vaccine not protect against?
Since the vaccine does not protect against all types of HPV, it will not prevent all cases of cervical cancers or genital warts.
Approximately 30% of cervical cancers will not be prevented by the vaccine, therefore it is important for women to continue getting screened by regular Pap tests even though they may have taken the vaccine.
What you can do to protect yourself from cervical cancer if you’re not in the recommended vaccine age group
HPV spreads through sexual contact.
The use of condoms protects against HPV infection.
Limit the number of sexual partners.
Stop smoking, it doubles the risk of cervical cancer.
Have regular Pap tests and pelvic exams.
Delay the first sexual encounter until the late teens or early twenties if possible.
Treatment of cancer of the cervix
Pre-invasive disease
Treatment of pre-invasive disease is simple and may consist of freezing for very early stages to conization for more advanced stages. When appropriately selected, the modalities are effective and prevent the progression of the pre-invasive disease to invasive cancer.
Invasive cancer of the cervix
Treatment may be:
Surgical for early stages.
Radiation and chemotherapy for more advanced cancers.
To conclude, cervical cancer is considered preventable, because it has a pre-invasive stage, effective screening is available for early diagnosis in the form of Pap smears and now, the first anti-cancer vaccine is available to prevent it. The future for women is bright in the battle against cancer of the cervix if they take appropriate measures and remain vigilant.
