sexually transmitted infections . The HPV virus typically infects cells on the surface of the skin lining , such as the genitals , anus , mouth and throat , but not blood or internal organs .
In a study published in the Journal of the American Osteopathic Association in 2006 , “ Epidemiology and Natural History of Genital Human Papillomavirus Infections ,” it was shown that approximately 80 percent of women had been infected with some type of HPV by the age of 50 . But , the author notes that , in general , most women with the virus do not develop cancer because the infections tend to be of short duration and typically resolve within two years as the infected cells shed from the cervix . Women suffering from persistent HPV infection , however , are at greater risk of developing cervical cell abnormalities that can lead to cancer .
According to the WHO , there are over 100 different strains of HPV , but most are low-risk and do not cause cancer . The most common high risk strains are HPV-16 and HPV-18 , which are linked to more than 70 percent of cervical cancers . This is because they contain two genes – E6 and E7 – that are responsible for the ability of HPV to cause cancer by inhibiting the functioning of key tumour suppressors , according to a 2005 report in Cancer Research and Treatment , a journal published by the Korean Cancer Association . For example , E6 inhibits p53 , a protein that controls responses to different types of cellular stress including DNA damage and viral infection , and E7 inhibits Rb , a protein that can prevent cell division .
The case for regular screening - The Pap smear and HPV test Regular screening for cervical cancer can save lives by detecting pre-cancerous cells early on , allowing for timely treatment before any cancer develops .
The first line of defence against cervical cancer is a Papanicolaou test or “ Pap smear ” which can detect the presence of precancerous or cancerous cells in the cervix . The screening test is simple , quick and painless and is performed by opening the vaginal canal and then gently scraping off cells at the outer opening of the cervix at the transformation zone . After applying a Papanicolaou stain , the cells are examined under a microscope for pre-malignant or malignant ( cancer ) changes . The smear is then analysed according to a set of uniform standards known as the Bethesda system . If the Pap smear results are abnormal , then further tests are done to determine if the patient has cervical cancer .
In addition to the Pap smear , women can also opt to take an HPV test , which can be done together with the Pap smear or as a separate test . Using a small brush to collect samples from the cervix , the HPV test is able to detect the presence of active , high-risk strains of HPV in the cervix , the type of strains that cause the abnormal changes in cells .
According to guidelines issued by the American Congress of Obstetricians and Gynaecologists
( ACOG ) in February 2016 , women between the ages of 21 and 29 should take a Pap smear test every three years . For those aged 30 to 65 , the ACOG recommends having a Pap smear and HPV test every five years or a Pap smear test alone every three years . The guidelines also call for screening in women who have been vaccinated against HPV .
In addition to screening , vaccines have also been effective in cutting the rate of cervical cancer . The two main vaccines currently available , Cervarix and Gardasil , are taken over a six-month period in three doses . According to an online article in the BBC published in August , the rate of cervical cancer in 130 countries has been halved since vaccinations were introduced over a decade ago . They work by producing immunity to HPV types 16 and 18 so that women who are exposed do not develop infections .
Is your lifestyle giving you cancer ? Lifestyle choices can greatly affect the chances of a woman developing cervical cancer . For example , women who have multiple sex partners increase their risk of contracting HPV , which also raises the possibility of developing cancer . The National Cancer Institute says there is also evidence that women using contraceptive pills over an extended period have a higher risk of cervical cancer . A number of other factors or lifestyle choices can raise the risk of getting cervical cancer , including :
• Being overweight and having a diet low in fruits and vegetables
• Smoking , as chemicals in tobacco damage the DNA of cells in the cervix
• Having a weak immune system or genetic variations
• Suffering from from high levels of stress over a sustained period of time
• Giving birth before the age of seventeen , compared with women who had their first baby when they were 25 or older .
It ’ s also important for women to be aware of their family history , as having a family member who has had cervical cancer increases the chance of other female members getting the disease . Having an inherited condition can make it that much harder to fight off an infection .
Maintaining a healthy cervix is vital to overall good health , and the best way to do that is by eliminating or reducing factors that can harm the body ’ s natural immune system and prevent it from working efficiently . Simple practices such as reducing one ’ s stress levels , eating a balanced diet , quitting smoking , and building up one ’ s immune system can help maintain overall health and protect the cervix .
Cervical cancer is largely preventable , provided that more women come forward for regular screening . The number of deaths from the disease would drop , and cervical cancer would no longer constitute a major global health problem . n
Leena Gauba is the Director of the Imperial Healthcare Institute , an award winning eye care hospital in Dubai . The facility treats patients from over 130 countries . Leena has a BSc ( Hons ) in Pharmacology with Management and an MSc in International Management from King ’ s College London . She also possesses a Diploma in Journalism from the London School of Journalism .
GlobalHealthAndTravel . com ISSUE 5 | 2024
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