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May 2018, Volume 68, Issue 5

Student's Corner

Cervical cancer caused by human papillomavirus: Highly preventable yet highly under-diagnosed

Muhammad Mustafa Memon  ( Dow Medical College, Karachi )
Emaan Amin  ( Dow Medical College, Karachi. )

Abstract

The link between human papillomavirus (HPV) infection and the development of pre-cancerous cervical lesions and cervical cancer is well known.1 High risk HPV types 16 and 18 account for 70% of cervical cancers and precancerous cervical lesions.2 The HPV test can be utilised as an effective instrument for diagnosing cervical cancer. Detection of HPV infection at an early enough stage can enhance the 5-year survival rate to about 93%.3 The \\\'Don\\\'t Just Sit There\\\' campaign was initiated across several states in Australia with the aim to improve the screening rate of cervical cancer. As a result, the number of Pap tests conducted during the campaign increased by 21% within a year.4 A 2017 report stated that in Pakistan, 62.8 million women aged 15 years and older are at risk of developing cervical cancer. Cervical cancer ranks as the 3rd most frequent cause of cancer and mortality in women of all ages in Pakistan. However, the current HPV screening coverage of Pakistani women aged 25-64 is only 2.3%.5 One factor that could be attributed to this alarmingly low screening rate could be the social taboos surrounding sexually transmitted diseases and infections like HPV.6 Hospitals in Pakistan do not commonly prescribe cervical cancer screening due to the lack of facilities and trained personnel. Furthermore, Ali SF et al. reported that only 40.5% of medical interns and nurses from different tertiary care hospitals in Karachi were aware of the appropriate screening test for cervical cancer.7 From the paucity of awareness shown among health care providers, it can be discerned that there would be an even lesser understanding of cervical cancer amongst the general population. Physicians and health care providers should, therefore, initiate programmes to spread knowledge about the prevention and screening of cervical cancer as there have been no such campaigns at a national level in Pakistan. Keeping in mind the results of the \\\'Don\\\'t Just Sit There\\\' campaign, similar initiatives should be taken as they have the potential to drastically boost the frequency of screening tests and hence detect thousands of new cases of HPV infections in Pakistan which would have otherwise gone undiagnosed.


Disclaimer: None to declare.
Conflict of Interest: None to declare.
Funding Sources: None to declare.

References

1.  Janicek MF, Averette HE. Cervical Cancer: Prevention, Diagnosis, and Therapeutics. CA Cancer J Clin.2001; 51: 92-114.
2. Human papillomavirus (HPV) and cervical cancer. [Online] 2015 [Cited 2016 Feb26]. Available from URL: http://www.who.int/ mediacentre/factsheets/fs380/en/.
3.  Survival Rates for Cervical Cancer, by Stage. [Online] 2016 [Cited 2017 Sep 21]. Available from URL: https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html.
4.  Cervical Screening Program campaigns [Online] 2016 [Cited 2017 Aug6]. Available from URL: https://www.csp.nsw.gov.au/campaigns.
5.  Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, et al. Human Papillomavirus and Related Diseases in Pakistan.[Online] 2017 [Cited 2017 Jan 17]. Available from URL: www.hpvcentre.net/statistics/reports/PAK.pdf.
6. Batool SA, Sajjad S, Malik H.Cervical cancer in Pakistan: A review. J Pak Med Assoc. 2017; 67: 1074-77.
7.  Ali SF, Ayub S, Manzoor NF, Azim S, Afif M, Akhtar N, et al. Knowledge and Awareness about Cervical Cancer and Its Prevention amongst Interns and Nursing Staff in Tertiary Care Hospitals in Karachi, Pakistan. PLoS ONE. 2010; 5: e11059.

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