YANGGON- Join the fight against cervical cancer

If so, January is the time to start. If you have never had a cervical cancer screening check or haven’t had one in the last few years, you may well be due for one. Cervical cancer leads to hundreds of thousands of premature deaths among women globally. But there are things women can do for prevention and early detection, which can halt or cure the disease. Too often, lack of awareness and access to screening means women are still dying of cervical cancer unnecessarily.

Cervical cancer is the growth of abnormal cells in the lining of the cervix which is the bottom part of the uterus (womb). Almost all cases of cervical cancer occur as a result of persistent infection with high-risk strains of a virus called human papilloma virus (HPV). HPV is spread by bodily contact, for example through skin-to-skin or sexual intercourse. It is very common – around three quarters of sexually active people will become infected with HPV before the age of 50. The infection is usually temporary as the body’s immune system will often clear the infection in most healthy people. However, persistent infections with high risk strains of HPV can lead to cervical cancer over time in susceptible women. In addition, cigarette smoking and having a weakened immune system can also increase your risk of cervical cancer.

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Cervical cancer develops slowly over several years. Some women may not experience any symptoms at all while other women may experience abnormal vaginal bleeding, pelvic pain, vaginal discomfort or odorous discharge. Abnormal bleeding may be in the form of spotting or heavy bleeding and can include bleeding that occurs between menstrual periods, after menopause and after sexual activity. As the symptoms may be vague or absent, it is best to perform screening at regular intervals to minimise your risk of developing cervical cancer. Because the cancer develops slowly, screening can detect pre-cancerous changes before they progress into cancer. If treated at an early stage, there is a high chance of cure.

Worldwide, there were 570,000 new cases of cervical cancer in 2018. While death rates from cervical cancer have fallen in many developed countries thanks to early diagnosis through effective screening programs, they remain very high in low- and middle-income countries where these screening programmes are not in place. In fact, 90 percent of deaths from cervical cancer occur in women from low- and middle-income countries. All too often, cervical cancer is not diagnosed until it is at an advanced stage or when treatment is no longer viable, leading to a high rate of death from cervical cancer in resource limited settings. Cervical cancer is the most common cancer in Myanmar women. In 2018, there were 6472 cases and over 3000 deaths due to cervical cancer reported in Myanmar. There are vaccines that protect against common cancer-causing types of HPV which can reduce the risk of cervical cancer by up to 90 percent. Nationwide HPV vaccination in Myanmar is planned to commence in 2020.

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Myanmar currently lacks a national screening program for cervical cancer. The World Health Organization (WHO) recommends that all women aged 30 to 49 should be screened at least once, followed by regular intervals of three to five years. Shorter intervals of observation may be needed for women who are found to have abnormalities or require treatment. Until a comprehensive national program for cervical screening is established in Myanmar, currently the onus is on women to initiate and attend regular screening for themselves through centres where cervical screening is available. So be bold and start your New Year right. Join the fight against the leading killer of women in Myanmar by attending cervical cancer screening or urging your female loved ones to do so.  /DR THEL KHIN HLA

Dr Thel Khin Hla is a doctor with the Myanmar Oxford Clinical Research Unit in Yangon.