Why the fuss about cervical cancer vaccine?

Cervical cancer ranks second after breast cancer in low-income countries. Worldwide, this disease is the fourth most frequently diagnosed cancer and cause of cancer death in women.

In Kenya, cervical cancer is the second most frequent cancer among women and the leading cause of cancer-related deaths.

What happens if I have precancerous lesions?

Precancerous conditions of the cervix are changes to cervical cells that make one more likely to develop cancer.

Precancerous lesions are not yet cancer, but there is a high chance these abnormal changes will become cervical cancer if they are not treated.

If left untreated, it may take 10 years or more for precancerous conditions of the cervix to turn into cervical cancer, but sometimes this happens in less time.

Cervical cancer and precancer lesions can be detected through a Pap smear test. For this test, your doctor/nurse looks inside the vagina using a device called a speculum. He or she will then use a small brush to collect cells from the cervix that will be examined in the laboratory.

Depending on your age, the doctor will also do a test for a virus called human papillomavirus (HPV). Alternative tests done in low resource settings include visual inspection with acetic Acid (VIA) or Lugols iodine (VILI). A screening test is not painful and provides information that can be life saving.

The recent launch of the HPV vaccine targeting over 800,000 girls aged 10 years old countrywide had many people wondering why the fuss about HPV and if indeed the vaccine will lead to a reduction of new cervical cancer cases and protect young women against early deaths.

HPV is the main cause of cervical cancer. It is a common virus that is passed from one person to another during sex.

Most sexually active people will have HPV at some point in their lives, and most infections will clear out without doing any harm.

Factors that increase the risk of cervical cancer are sex debut at an early age, multiple sexual partners, sexually transmitted diseases, HIV and cigarette smoking.

So how does vaccinating young girls against HPV help prevent the scourge?

The vaccine is used to prevent the HPV types that cause most cervical cancers as well as some cancers of the anus, vulva (area around the opening of the vagina), vagina, and oropharynx (back of throat including base of tongue and tonsils).

Ideally, the vaccine should be administered to girls and women before they become sexually active and exposed to HPV. The World Health Organisation recommends vaccination to start at 10 years of age.

The good news is that the development of cervical cancer from the time of HPV infection usually takes over 10 years, hence there is plenty of time to screen women who are sexually active and find out if they are carrying the virus or if they have developed precancerous lesions that can easily be treated.

Women between the ages of 25 to 64 are advised to have Pap smears every three years. However, HIV positive women are urged to undergo the procedure every year.

Screening is very important even for women who have already received the HPV vaccine. This is because the vaccine does not protect against all types of cervical cancers and regular screening will catch precancerous cells before they become cancer.

Prof Marleen is the chair, Department of Obstetrics and Gynaecology at Aga Khan University Hospital