Though cervical cancer is the second most common cancer among Indian women, there is a lack of awareness among people, leading to its late diagnosis and therefore death in many cases. Doctors suggest that a Pap smear, one of the crucial tests to diagnose cervical cancer at an early age, must be regularly taken by women.
“This is a crucial test that all women should undergo for early detection and treatment of cervical cancer,” says Dr Suhasini Inamdar, consultant, obstetrician and gynaecologist, Motherhood Hospitals, Bengaluru. The test involves the collection of cells from the cervix to determine any changes due to HPV (Human papillomavirus) which causes cervical cancer. Diagnosis at an early stage increases the chances of cure. Getting a Pap smear done is the first step towards stopping the progression of the disease.
“A Pap smear also determines any abnormal changes in cervical cells which may suggest chances of development of cancer in the future. The level of awareness among Indian women is quite low, especially when compared to developed countries. There is a stark difference in awareness, attitude and frequency of testing, especially in rural areas. In fact, many women aren’t even aware of cervical cancer even though it is the second most common type of cancer among women in the country. This results in a lack of testing and diagnosis in the early stages. Also, the socio-economic status of the women and the place where they reside also make a difference in the level of awareness. It is heart-breaking that so many women have lost their lives to cervical cancer, a disease which can be preventive measures of cervical cancer and treated through vaccination and regular screening,” she says.
“Cervical cancer is more common in sexually active women and it is caused by a virus called the HPV virus, which affects the mouth of the womb or the cervix,” says Dr Prathima Reddy, director and lead consultant, department of obstetrics and gynaecology, SPARSH Hospital for Women and Children. She says that the Pap smear test is offered to all women between 25 and 64. “A pap smear (cervical smear) is a test of the cervix or the mouth of the womb. Your doctor will take a sample of cells from the cervix which will then be read by a pathologist under a microscope. It’s important to remember that a Pap smear is done to help prevent cancer and not to detect cancer. So, it is a screening test that is done to detect precancerous cells before they turn into cancer. This is a key differentiator,” she points out. She further adds that women between 25 to 49 should undergo a Pap smear test every three years. “If one has had normal Pap smears up to the age of 49, they can then take the test once every five years and up to the age of 64. The HPV test is now replacing the Pap smear test. In the west, the HPV test is done as the first line of screening as opposed to a Pap smear,” says Dr Reddy.
Dr Inamdar explains that cervical cancer generally does not produce any noticeable signs and symptoms in the early stages. Women tend to notice the signs only when it has reached a more advanced stage, but by then it could be too late. Pap test helps reduce the risk of the development of cervical cancer. It helps help in the early diagnosis of the disease and appropriate treatment can be started as soon as possible.
“Certain women may have risk factors that make them more vulnerable to cervical cancer, like a history of smoking, a weakened immune system due to medical treatments or an HIV infection. In such cases, the frequency of Pap tests should be increased,” she says.
Delay in getting Pap tests done will increase the risk of the development of cervical cancer, says Dr Inamdar. The disease is entirely preventable but even so, several women have tragically lost their lives to it. “To prevent this, early and regular screening is essential. Pap tests help in doing this. They give women a fighting chance against cervical cancer causes and prevention and help them lead long and happy lives. Therefore, it is important not to give this a miss, as there are high chances that cervical precancerous changes may go unnoticed or undetected until it has reached an advanced stage,” she says.
Dr Reddy explains that the precancer can turn into cancer. “For example, let’s say a woman gives a gap of 10 years between two Pap smears. There is a chance that the woman may develop cancer in these ten years, which therefore defeats the whole purpose of this screening test. As previously stated, a Pap smear detects precancerous cells, allowing for treatment of the disease before it turns into cancer. This has far better outcomes than treating the cancer itself,” she says.
