Cancer of the cervix is a mass gender killer. It is still the No. 1 cancer of women in many countries including Cambodia and my country of origin, Malaysia. This disease is peculiarly gender unfair where women are always the victims and men the cause of it. The more men a woman sleeps with, the more likely she is going to have cancer of her cervix. The perfect antidote of this cancer is celibacy but the lure of sex and human desire for self-propagation are unstoppable.
Many years back when I was a medical student, my professor of gynaecology told me, “No sex means no cancer of cervix”. That was confirmed by a study done on a group of nuns who practiced celibacy. None of them eventually developed cervical cancer. Nonetheless, the ultimate cause of this form of cancer still remains unknown.
There was a time, medical students would pass their gynaecology examination by telling their professor that the likelihood of having cervical cancer increases when a woman commences sex at an early age, has multiple sexual partners, smokes cigarettes and belongs to a lower socioeconomic group.
Until 1984, nobody knew that it is the elusive Human Papillomaviruses (HPVs) that cause the notorious cancer. Man is the host of the HPVs and ‘vector of transmission’ of cancer of the cervix. To date, scientists have discovered more than 150 species of HPVs, some of them responsible for causing cauliflower-like warts known as papilloma – a term incorporated as part of the name of this group of viruses. Out of these 150 known species of HPVs, about 15 of them have the potential to cause cancer of the cervix.
In 1984, Professor Harald zur Hausen, a German virologist successfully attributed cervical cancer to HPV species No.16 and No.18. This important discovery sparked off a series of other developments towards better prevention of this form of cancer. Many lives have been saved since then. Professor Harald was rightfully conferred the Nobel Prize in Physiology or Medicine in 2008.
The discovery of the HPVs as the cause of cancer of the cervix contributed greatly to the discovery of HPV vaccines that prevent many women from getting HPV infection, cancer due to the infection, and death due to the cancer.
About 79 million Americans, mostly in their late teens and early 20s, are infected with HPV. Each year, about 14 million people become newly infected. HPV infection is so common that almost every person who is sexually active will get HPV at some time in their life if they don’t get themselves vaccinated with the HPV vaccine. It is said that the annual HPV infection is as common as influenza infection.
According to a report from the US-based Centres for Disease Control and Prevention, published in The Journal of Infectious Diseases in 2013, the prevalence of vaccine-types HPV infections – after the introduction of the HPV vaccine in girls aged 14 to 19 – showed a significant decrease of 56 percent.
“This report shows that the HPV vaccine works well, and it should be a wake-up call to protect the next generation by increasing HPV vaccination rates,” said CDC director Dr Tom Frieden.
“Unfortunately only one third of girls aged 13-17 have been fully vaccinated with HPV vaccine. The low vaccination rates represent 50,000 preventable tragedies – 50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if the vaccination rate reached 80 percent. For every year of delay in doing so, another 4,400 girls will develop cervical cancer in their lifetimes,” he added.
This article highlights the importance of HPV vaccination in the control and prevention of a widespread infection that leads to the devastating No. 1 cancer of women. The vaccine is now available in many countries including this country (in some clinics only). It is highly effective, especially its newer version that can prevent up to 90 percent of the cancer-causing HPV infection and its related cancer – an improvement of 20 percent from the old vaccine.
With the availability of the vaccine, the power of control of cancer of the cervix is now shifted from doctors to patients. The patient’s decision is of utmost importance. They are the ones who will decide to say, “Yes, I want the vaccine. I want it early to prevent 90 percent of cervical cancer.” Given early at 9 to 13 years old, they need only 2 doses. Above that they need 3 doses. They are expensive. Nonetheless, those who can afford it should have it and have it early for better protection.
It should be pointed out that PAP smear or PAP test that is recommended to be done once in 3 years for all sexually active women age between 21 to 69 is another effective way to detect precancerous abnormalities at its early stage so that proper treatment can be instituted to prevent the actual development of cancer of the cervix. This common practice in neighbouring countries such as Singapore and Malaysia should be encouraged to further lower the incidence of the devastating cervical cancer in this country. Interested individuals may contact us for the vaccination or test.
My next column will be on ‘Fatty liver – The sick liver.’
Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases, excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skills in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected] Tel: 023900446 or Whatsapp: +60164122977