The world yesterday celebrated International Women’s Day. Although it is important to consider various issues pertaining to women, their health needs ought not to be forgotten. One such issue is cancer of the cervix which is preventable. Cancer of the cervix (lower part of uterus) is one of the most common malignancy affecting women in the developing world. Tragically, it mostly affects the poor women who are ignorant, have no access to early diagnosis and early treatment.

This cancer occurs commonly in women who start sexual activity early and have multiple sexual partners. Recurrent infections of the genital tract and repeated child birth are other factors which predispose to it. Reduced immunity particularly in HIV-positive women makes them more susceptible to develop cervical cancer although human papilloma virus (HPV) is the most common identified cause for cervical cancer. This virus can be acquired and transmitted by sex.

There may be abnormal bleeding from the genitals in affected women. Bleeding after intercourse, painful intercourse, excess bleeding in between menses are the other symptoms which can occur. Vaginal discharge if present may be mistaken for infection thus delaying the diagnosis and early treatment. In fact, vaginal discharge in a woman above 40 years should always alert one to the possibility of cancer of the cervix.

As the cancer spreads to the adjoining parts of the pelvis it may cause burning during urination, low backache, pain and parasthesias in the buttocks and thighs. Systemic spread is also possible in the advanced stages, affecting other parts of body like intestines, kidney, e.t.c.

Diagnosis of the cervical cancer is done by carrying out a very simple test named "Pap smear ( short form for Papanicalou smear). In this, the vaginal swab is examined under the microscope and in case of any suspicion, a biopsy of the cervix is taken and examined.

Screening for cancer of the cervix is recommended to start as early as around 20 years when women begin their sexual activity. After 2 consecutive negative tests done annually, tests should be repeated every 3 years. But in poor communities, it can be done once every year, more so in women above 40 years. A middle-aged woman complaining about vaginal discharge should always be screened for cervical cancer.

When diagnosed in the initial stages, surgery is done which provides total cure. But in advanced stages, surgery if done is palliative just to provide relief. Radiation, which is used to burn the cancerous cells, also comes with many side effects. Chemotherapy when done is expensive and painful with many adverse effects.

Girls should be advised against starting sexual activity at a very early age. One should stick to one sexual partner all the life to avoid sexually transmitted diseases, HIV and cervical cancer.

Good hygiene of genital parts is helpful in preventing infections and also reduces risk of cancer.

Measures undertaken by the Ministry of Health regarding sensitization of women about prevention of cervical cancer are laudable. Already adolescent and teenage girls are being vaccinated against HPV for its prevention

If one experiences any of the symptoms of cervical cancer, she should go forward for being tested. Early treatment of cervical cancer does ensure a long and productive life.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital

rachna212002@yahoo.co.uk