Cervical cancer awareness month: Common myths surrounding HPV busted!

Cervical cancer is a major health concern in India, ranking as the second leading cause of cancer-related deaths among women. According to the International Agency for Research on Cancer (IARC), India recorded over 14.13 lakh new cancer cases and 9.16 lakh deaths in 2024. In 2022 alone, 79,906 women died due to cervical cancer. The survival rate largely depends on early diagnosis, with surgery offering an 85-90% cure rate in the early stages.

Dr Vandana Jain, Senior Consultant and Head of Department- Gynaecologic Oncology, Rajiv Gandhi Cancer Institute and Research Centre said, “One of the challenges with cervical cancer is that it often remains asymptomatic in its early stages.”

Minor symptoms that appear include abnormal vaginal bleeding, such as bleeding between menstrual cycles, after intercourse, or post-menopause. Women may also experience heavier or prolonged periods, unusual watery or foul-smelling discharge, and persistent pelvic or lower back pain. In advanced stages, symptoms such as blood in urine or stool, chronic coughing, bone pain, or unexplained weight loss may indicate cancer has spread to other organs.

Progress of the disease

The cancer progresses through various stages, starting from the precancerous stage, followed by stage I to stage IV, where it spreads to other organs. In the early stages, the survival rate is around 85 per cent to 90 per cent. 

If the patient seeks help early, the chances of a cure are high with surgery, with or without additional treatment. However, once the disease becomes locally advanced, the opportunity for surgery is lost, and treatment shifts to chemoradiation, external beam radiation, and brachytherapy with concurrent chemotherapy. Consequently, survival rates decline compared to the early stage.

Thus keeping a watch on symptoms, however subtle is crucial.

Jain lists the following myths surrounding HPV- the virus behind cervical cancer.

· HPV infection is not always fatal. While nearly 80% of sexually active women will acquire the virus at some point, most will clear it naturally within 2–3 years if they have a strong immune system. If the infection persists beyond two years, it increases the risk of developing cancer in the future.

· HPV does not spread through casual touch, such as handshakes or hugs. It is primarily transmitted through genital contact, including vaginal, anal, and oral sex, as well as contact with infected genital secretions.

· HPV infection is not necessarily lifelong. While many people clear the virus on their own, some may develop a persistent infection, especially if they have risk factors such as smoking, prolonged use of oral contraceptives, poor genital hygiene, multiple sexual partners, co-existing STIs, HIV, autoimmune diseases like lupus (SLE), or long-term steroid use. 

High-risk strains, particularly HPV types 16 and 18, are more likely to persist and lead to cancer. HPV vaccination plays a crucial role in preventing infection with these high-risk strains, significantly reducing the chances of cervical and other HPV-related cancers.

Screening

The surest strategy to tackle cervical cancer is to opt for screening through pap smear tests or HPV testing.

In resource-limited settings, Visual Inspection with Acetic Acid (VIA) serves as an inexpensive and practical screening alternative, allowing healthcare providers to identify abnormalities visually and conduct a biopsy if needed.

Routine screening should ideally begin at age 21 with a Pap smear. For women over 30, co-testing with a Pap smear and HPV test, or HPV testing alone, is recommended every five years.

Treatment

As for treatment options, surgery remains the most effective option for early-stage cervical cancer. However, as the cancer advances, treatment becomes more complex. In later stages, chemoradiation, which combines external radiation, brachytherapy, and chemotherapy, is the primary treatment option, with a survival rate of 50-60%. For metastatic cases, chemotherapy and immunotherapy can help manage the disease and prolong life.

Other preventive factors

Prevention plays a crucial role in reducing the risk of cervical cancer. 

1. A healthy lifestyle, avoiding smoking, maintaining hygiene, and practising safe sexual behaviour contribute to lowering the chances of developing the disease.

2. Access to regular screening, particularly for women in underserved areas, is vital. 

3. Mobile health units can provide essential screening services to detect abnormalities early. 

4. The HPV vaccine is another preventive measure, recommended for boys and girls between the ages of 9-12. It offers protection against common high-risk HPV strains and significantly reduces the likelihood of developing HPV-related cancers.