Cervical cancer
Prepared by
DR.RAVICHANDRA VARMA S
WHAT IS CANCER?
CANCER IS AN ABNORMAL AND AN
EXCESSIVE GROWTH OF CELLS WHICH
ARE INCAPABLE OF DOING NORMAL
PHYSIOLOGICAL FUNCTION
WHAT IS THE FEMALE RE
PRODUCTIVE TRACT ?
Vulva
Vagina
Cervix
Uterus
Fallopian tubes
Ovaries
WHAT IS THE CERVIX ?
Opening of the
uterus (womb) into
the vagina
Cancer that affecting
Cervix is called
cervical cancer
The central cause of cervical cancer is
human papillomavirus or HPV:
HPV is transmitted through sexual contact
The HPV detected today could have been
acquired years ago
There are many different types of HPV that
can infect the cervix, vagina and vulva
‘Low-risk’ types may cause genital warts
‘High-risk’ types may cause precancer and cancer of the
cervix
• Most women who are infected with HPV will
never have any symptoms
WHAT CAUSES CERVICAL CANCER
?
CERVICAL CANCER IS THE CANCER
AFFECTING THE CERVIX OF THE UTERUS
2ND MOST COMMON CAUSE OF CANCER
DEATH IN THE WORLD AND 1ST CAUSE IS
THE BREAST CANCER
How common is HPV?
Most men and women who have
had sex have been exposed to HPV
More than 75% of sexually active
women have been exposed to
HPV by age 18-22
If I have HPV, does it mean I will
get cancer?
NO!
In most cases HPV infection will
go away
Only women with persistent HPV
(where the virus does not go
away) are at risk for cervical
cancer
EARLY MARRIAGE
YOUNG AGE AT FIRST PREGNANCY
SHORT INTEVAL BETWEEN PREGNANCY
POOR NUTRITION
POOR HYGEINE
WOMEN WITH STD
WOMEN WITH MULTIPLE SEXUAL PARTNER
HUSBAND WITH MULTIPLE SEXUAL PARTNER
SMOKING
WHO IS AT RISK ?
How do I lower my risk?
Delay onset of sexual activity or remain
abstine
Do not smoke
Maintain a healthy diet and lifestyle
Practice safe sex. Condoms decrease the
chance of HPV exposure.
If eligible, consider getting the vaccine
that prevents most cervical cancers.
Get your Pap test and HPV testing as
recommended by your health care
provider.
SYMPTOMATOLOGY
ASYMPTOMATIC IN EARLY STAGES
BLEEDING
- POST COITAL
- INTERMENSTRUAL
- POST MENOPAUSAL
VAGINAL DISCHARGE
PAIN
RECTAL / URINARY SYMPTOM
Prevention & Early Detection
Cancers that can be prevented or detected early by
screening account for at least 50% of all new cancer
cases.
Cancer Facts & Figures 2009
How we can prevent?
1.Vaccination
2.Regular pap smear screening
Vaccination
human papilloma vaccine
Prophylactic HPV Vaccine
Approved for Adolescent Girls
Vaccine HPV Types FDA approved Age range
Bivalent 16/18 2009 10-25* yrs
Quadrivalent 6/11/16/18 2006 9-26* yrs
*Routine vaccination for 11-12 year old females
Three doses of vaccine given intramuscular
route at 0,2months and 6months
Screening
CERVICAL CANCER – IDEAL FOR
SCREENING
CERVIX EASILY ACCESSIBLE FOR
EXAMINATION
LONG LATENT PRECANCEROUS PHASE
NATURAL HISTORY KNOWN
What is a Pap test?
Cells are collected from the surface of
your cervix by a doctor
These cells are then checked under a
microscope for any abnormalities
If abnormal (or precancerous) cells
are found, they can be treated before
they turn into cancer
Cervical cancer can be found in the
early stages, when it is easier to treat
Papanicolaou test –
exfoliative cytology
test
cells collected are
from normally
shedding epithelium
.
◦ collected using
spatulas or brushes.
◦ Specimen is fixed,
stained and studied
for morphology under
microscope.
PAP SMEAR
AYRE’S SPATULA
SAMPLING INSTRUMENTS
Spreading
Spread the material collected on the
spatula / cervix brush evenly over the
slide with a painting action and single
smooth stroke motion using both sides
Finding early cell changes
Normal cervical cells Precancer
cells
Pap Smear Guidelines: 2009
American College of Obstetrics and
Gynecology
<21 Years 21-29 Years 30-64 Years ≥65 Years
Pap smear every 3
Consider
No routine Bi-annual years
discontinuing Pap
Pap smear Pap smear smear at 65 or 70
..if patient has had years
3 or more normal
Pap results in a row,
no abnormal test ..if patient has had
results in 10 years, 3 or more normal
and lacks other risk Pap results in a row,
*History
of cervical cancer or DES in utero, HIV factors.* no abnormal test
positive, immunosuppression, or other risk factors results in 10 years,
for acquiring STDs. and lacks other risk
factors.*
ACOG Practice Bulletin No. 109. Obstet Gynecol. 2009;114:1409-20.
Most cervical cancer can be
prevented
Cervical cancer is very rare in women
who get regular Pap tests
Barriers to women’s
participation in screening:
Little understanding of cervical cancer
Limited understanding of female reproductive organs
and associated diseases
Lack of access to services
Shame and fear of a vaginal exam
Fear of death from cancer
Lack of trust in health care system
Lack of community and family support
Concept of “preventive care” is foreign
Common misconceptions about
cervical cancer:
People often do not know that it is preventable
Belief that screening involves STI/HIV screening
Belief that a positive/abnormal Pap smear result
means a woman will die
Research found that:
◦ In South Africa and Kenya, women often think a
positive screening test means they have HIV
◦ In Mexico, women fear that treatment will leave
them sexually disabled
What We Do – Save Lives
Helping people stay well
By educating them on steps they can take to prevent
cancer and find it early
Helping people get well
By providing accurate and timely informational, emotional,
and practical support services
Funding cancer research
To further understand its causes, determine how best to
prevent it, and discover new ways to cure it.
Fighting back against cancer
By supporting the indian Cancer Society and those in your
life who are affected by cancer, you can join us in creating
a world with more birthdays!
We can End Cervical Cancer
Policy Makers
Vaccination
Screening
Questions?
