Preventive measures for cervical cancer: Not just for girls

to raise awareness of cervical cancer prevention

 

Cervical Cancer Prevention Week, organised by Jo’s Cervical Cancer Trust, commences on 18 January and aims to educate people on how they can reduce their risk of cervical cancer [1].

Among women, cervical cancer is the fourth most common cancer and, staggeringly, around 90% of the deaths from cervical cancer occur in low- to middle-income countries [2]. During the past 25 years, the incidence and death rate of the disease have decreased; however, despite these promising statistics, the 5-year survival rate of patients with cervical cancer is only 66.1% [3 In support of Cervical Cancer Prevention Week, in this article we will discuss the measures that can be taken to reduce the risk and burden of cervical cancer.

HPV vaccines are available for boys and girls
Human papillomavirus (HPV) is a very common virus, and there are more than 100 strains [2]. At least 14 strains of the virus are known to cause cancer, and two specific types – HPV-16 and HPV-18 – cause 70% of cervical cancers and 40%–60% of precancerous cervical lesions [2, 4]. There is also evidence linking HPV with cancers of the anus, vulva, vagina, penis and oropharynx [2].
There are currently two vaccines with high efficacy that protect individuals against infection and precancerous cervical lesions caused by HPV-16 and HPV-18 [4]. Since 2008, girls aged 11 years and over in Scotland and girls aged 12 years and over in the rest of the UK are eligible to receive an HPV vaccine [5]. In addition, it has been shown that the vaccines could also protect boys from other HPV-related cancers and promote ‘herd immunity’ among children who have not been vaccinated. For this reason, since September 2019, boys aged 12 years and over have also been eligible to receive the HPV vaccine in the UK [5, 6].

Cervical screening could save your life
In the UK, women aged 25–49 years are entitled to attend free cervical screening appointments (also known as ‘smear tests’) every 3 years; the intervals are then reduced to every 5 years for women aged 50–64 years [7]. The purpose of cervical screening is to prevent cervical cancer by looking for the presence of high-risk HPV strains and to check the cervix for any precancerous lesions [7].

During cervical screening, a small sample of cells is taken from a woman’s cervix and then tested for high-risk HPV strains [7, 8]. If there are none present, no further tests are required until the next routine cervical screening [8]. However, if any high-risk HPV strains are found, the sample will be further analysed to identify any changes in the cells of the cervix; this can allow precancerous lesions to be treated before the condition evolves into cervical cancer [8].

Cervical screening is an extremely valuable opportunity to detect any abnormalities before it is too late. Women are still able to receive cervical screenings during the COVID-19 pandemic – if you can, please attend your cervical screening appointment.

Be aware of the initial symptoms
Unusual bleeding is usually the first noticeable symptom of cervical cancer [9]. This includes bleeding during or after sex, between your periods or after you have been through the menopause [9]. Other symptoms include pain and discomfort during sex, unusual or unpleasant vaginal discharge, and pain in your lower back or pelvis [9].

How we can protect ourselves and others
According to Cancer Research UK, 99.8% of cervical cancer cases are preventable [10]. There are simple measures that everyone can take to reduce their risk of HPV-related cancers:
1. Attend your free cervical screening appointment when provided with the opportunity to do so.
2. Take the vaccine. If you did not receive the vaccine during your school years, you are eligible to receive the vaccine for free up until the age of 25 years (this applies to men and women).
3. Be aware of the symptoms. If you experience any, medical advice should be sought immediately.
4. Raise awareness of the disease and the important preventive measures for cervical cancer. Join the #SmearForSmear campaign organised by Jo’s Cervical Cancer Trust, which aims to dissolve the stigma and fears around cervical screening.
5. Know where to find support and further information. If you need further support, please visit: https://www.jostrust.org.uk/get-support

References
1. Jo’s Cervical Cancer Trust. Cervical Cancer Prevention Week 2021. Available at: https://www.jostrust.org.uk/get-involved/campaign/cervical-cancer-prevention-week. Accessed January 2021.
2. World Health Organization. Human papillomavirus (HPV) and cervical cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer. Accessed January 2021.
3. National Cancer Institute. Cancer Stat Facts: Cervical Cancer. Available at: https://seer.cancer.gov/statfacts/html/cervix.html. Accessed January 2021.
4. Arbyn M, Weiderpass E, Bruni L et al. Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. Lancet Glob Health 2020; 8 (2): e191–e203.
5. Jo’s Cervical Cancer Trust. Who can have the HPV vaccine? Available at: https://www.jostrust.org.uk/information/hpv-vaccine/who-can-have-the-hpv-vaccine. Accessed January 2021.
6. HPV Action: Jabs for the Boys. Jabs For The Boys: Let’s beat HPV. Available at: http://jabsfortheboys.uk/. Accessed January 2021.
7. National Health Service. Overview: Cervical cancer. Available at: https://www.nhs.uk/conditions/cervical-cancer/. Accessed January 2021.
8. Jo’s Cervical Cancer Trust. What happens at cervical screening? Available at: https://www.jostrust.org.uk/information/cervical-screening/what-happens-during-cervical-screening. Accessed January 2021.
9. National Health Service. Symptoms: Cervical cancer. Available at: https://www.nhs.uk/conditions/cervical-cancer/symptoms/. Accessed January 2021.
10. Cancer Research UK. Cervical cancer statistics. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer. Accessed January 2021.

Author: Sera Moore, Medical Writer, Porterhouse Medical