tracing contact/ partner & treatment for stis , wherever possiblecancer
cervix is the leading cancer in indian women and the second most common
worldwide. the precancerous changes start early, usually in the twenties, once
the women is sexually active and if undetected and untreated may turn into a full blown cancer by the time
the woman is in her 50s.
there are several good things about this cancer.
Ø it is a preventable cancer.
Ø a known etiology, a hpv ( human
Ø a known mode of spread i.e sexually
Ø a very good and inexpensive screening
test called pap smear which identifies it several years ahead at a precancerous
stage making it amenable to prevention and early treatment with good prognosis.
Ø an effective vaccine
Ø unlike other stis (sexually
transmitted infections) it is not fully protected by condoms.
we live in an
era of sexual liberalisation with far reaching consequences. stis are a rising concern, with long term consequences. hiv
is just the tip of iceberg.
risk factors are those with
initiation of sexual activity
knowledge of contraception
in using barrier method by male partners
socio-economic status with poor access to health care services, including pap
prison inmates, drug addicts, those
attending sti clinics
low immunity status like hiv, use of birth control pills for > 5 years,
being younger than 17 at the time of first delivery, multiparity i.e having 3
or more children.
first wife dying of a cervical cancer placed the second wife at high risk.
the familiarity with the disease, it continues to flourish especially in
developing countries. most of those who suffered rarely made to the hospital in
time. educated women, even doctors hardly turned up for their pap smear in
time. may be it was a feminine trait, being indifferent to their own health.
effective vaccine lay underutilised because of unawareness and sometimes non
a report published by the centers for disease
control and prevention (cdc) tells,
young people aged 15-24 years
develop half of all new sexually transmitted infections (stis),
1 in 4 sexually active
adolescent females has an sti
the lower limit of giving hpv vaccine, that acts best when given before the
sexual debut has been brought down to 9 years of age; a definite sign of
is one result of a sexually saturated culture and the myth perpetuated by
academe, medicine and pharmaceutical companies that latex, contraception and vaccines can make all sexual behavior risk
even among prime-time network television
shows, there is only 1 portrayal of protective behavior or comment regarding
stis for every 25 instances of sexual behavior shown.
sadly one-quarter of adolescents and young
adults in high-risk age groups for stis did not have health care coverage.
only 11 percent of teenagers surveyed
reported getting most of their information regarding stis from their parents or
other family members.
knowledge and awareness of stis among the
public is poor; almost two-thirds of women,18-60 years of age surveyed knew
nothing or very little about stis other than aids.
young women and female adolescents are more
susceptible to stis compared to their male counterparts because of their
biological characteristics. during puberty and young adulthood, specific cells
(columnar epithelium) are especially sensitive to invasion by certain sexually
transmitted organisms are more exposed.
women and female adolescents may also find
it more difficult than men to implement protective behaviors, partly because of
the power imbalance between men and women
the only way to
curb the rising epidemic was by :
- inculcating responsible behaviour
sounds like a cliché but if
you don’t take a detailed sexual history of your partner on your date, you
don’t know him well enough to have sex.
and ‘safe sex’ is sex with your faithful
- encourage use of contraception ( barrier
pap smear in sexually active women ( 21-65 years) at least every 3 year( even
in those previously vaccinated with hpv vaccine), or combining it with hpv
testing every 5 years ( >30 years of age).
and “screen, diagnose and treat” are both valuable approaches
- promoting cervical cancer vaccine; may be a
government initiative making the vaccine cost effective, mandatory or even
free to all adolescent girls.
- health education
- tracing contact/ partner & treatment for stis , wherever possible