Cervical Cancer Screening: Empowering Women with Knowledge and Insurance Solutions

Cervical cancer ranks fourth among cancers that affect women worldwide, with 604,000^[1] new cases in 2020. Thus, it is imperative we pay attention to, comprehend, and take proactive steps to prevent and identify this disease as soon as possible.

What is cervical cancer?

Cervical cancer is the gradual, progressive development of cancer cells that start in the cervix and spread over time. The cervix is the narrow end of the uterus that connects to the vagina.

Before cancer begins in the cervix, the cervical cells go through 'dysplasia,' in which abnormal cells begin to appear in the cervical tissue. If left unchecked, the cells can develop into cancerous ones that eventually invade the cervix and its surrounding tissues.

Numerous women worldwide are affected by gynaecological cancer of various sorts in addition to cervical cancer. As such, women need to have all the information they require about these illnesses.

Cervical cancer symptoms

When signs of cervical cancer in its early stages do manifest, they may include:

• Vaginal bleeding during menopause, sexual activity, or in between periods.

• Menstrual bleeding is heavier and/or than usual.

• Watery, foul-smelling bloody vaginal discharge.

• Pelvic pain or discomfort during intercourse.

 

 

Advanced cervical cancer may present with symptoms of early-stage cervical cancer and the following:

• Painful bowel movements or rectal bleeding.

• Difficult or painful urination.

• Blood in the urine.

• Swelling in the legs.

• Abdomen pain.

• Fatigue.

• Appetite loss.

• Weight loss.

 

 

You must see an oncologist if you have any of these symptoms, particularly if they are uncommon or persistent.

Cervical cancer staging

The International Federation of Gynecology and Obstetrics^[2] staging system is the most widely utilised one for cervical cancer.

The FIGO staging for cervical cancer is summarised as follows:

• Stage I:  Cancer has formed and is found in the cervix only.

• Stage II: The cancer has progressed to the tissue around the uterus or the top two-thirds of the vagina. However, the pelvic wall and the lower vaginal wall have not been affected.

• Stage III: The cancer has spread to the pelvic wall, ureter, lymph nodes, and the bottom portion of the vagina.

• Stage IV: The cancer has progressed beyond the pelvis to the lining of the bladder or rectum, as well as other organs, including the lungs.

 

 

Cervical cancer causes

The human papillomavirus (HPV) is a common virus that is transferred through sexual contact and is responsible for 99%^[3] of cervical cancers. HPV can affect the skin, vaginal tissue, and the throat. Even while the majority of HPV infections are symptomless and resolve on their own, persistent infections have the potential to cause aberrant cells to develop into cancer.

Cervical cancer may eventually develop from the precancerous lesion if it is not identified and removed.

Cervical cancer risk factors

Although having a high-risk HPV infection is a major risk factor, the following variables may increase the likelihood of developing cervical cancer:

• A weakened immune system lowers the body’s capacity to fight HPV infections.

• Inhaling secondhand smoke or smoking yourself can harm cervical cells and raise your chance of getting cervical cancer.

• Reproductive factors include taking birth control pills and having a large family.

• Obesity leads to lower detection of precancers and a higher risk of cancer, as cancer screening may be more difficult.

• Lack of HPV vaccination.

 

 

How is cervical cancer diagnosed?

There are many tests used for diagnosing cervical cancer.

Cervical cancer testing

Cervical cancer testing uses a variety of screening and diagnostic techniques aimed at finding abnormalities in the cervix, such as precancerous alterations or early-stage cancer.

Tests commonly used to diagnose cervical cancer include:

• Pap test

• HPV test

• Colposcopy

• Biopsy

  • Punch biopsy

  • Cone biopsy

  • Endocervical curettage

  • Loop electrosurgical excision procedure (LEEP)

• Imaging tests

  • Magnetic resonance imaging (MRI)

  • Computed tomography (CT) scans

  • Positron emission tomography (PET) scans

• Lab tests

  • Complete blood count (CBC)

  • Blood chemistry study

• Visual tests

  • Cystoscopy

  • Sigmoidoscopy

 

 

Regular testing, such as Pap smears and PHV tests is crucial for early detection and improved outcomes.

Cervical cancer treatment

The cancer stage, the patient's general health, and their personal preferences are some of the variables that affect cervical cancer treatment.

Cervical cancer treatment options can include one or a combination.

Radiation

Radiation therapy uses high-energy X-rays to eradicate cancer cells and treat cervical cancers that have spread to other organs and tissues. Chemoradiotherapy—radiation combined with chemotherapy—is used to help prevent cancer from returning following surgery.

Treatment with radiation alone or radiation with surgery is recommended for certain stages of cervical cancer.

Several types of radiation therapy:

• External beam radiation therapy (EBRT): Radiation therapy with a high dosage is applied externally to the malignant cells.

• Internal radiation therapy (Brachytherapy): Radioactive materials are positioned inside or close to the tumour to deliver radiation directly to the cancer cells. External beam radiation is frequently combined with this.

 

 

Chemotherapy

Anti-cancer medications either eradicate cancer cells or inhibit their proliferation. Chemotherapy can be given intravenously or orally. The primary treatment is chemotherapy plus radiation (chemoradiotherapy), which improves the effectiveness of the radiation.

Chemotherapy medications used to treat cervical cancer include:

• Cisplatin

• Carboplatin

• Gemcitabine

• Ifosfamide

• Irinotecan

• Paclitaxel

• Topotecan

• Vinorelbine

 

 

Surgery

During surgery, the cancerous tissue is removed. Cervical cancer can be treated (particularly in the early stages) and diagnosed with surgery.

Types of surgical procedures include:

• Conisation

• Simple or total hysterectomy

• Radical hysterectomy

• Trachelectomy

• Pelvic exenteration

• Lymph node dissection (Lymphadenectomy)

 

 

Precision medicine

Precision medicine is a personalised genomic medicine that considers individual variations in behaviour, environment, and genetics. Consequently, this aids in the more accurate diagnosis of cancer and the administration of appropriate, tailored treatment by medical specialists.

Immunotherapy

Immunotherapy strengthens a person's immune system to identify and eliminate cancer cells more successfully using drugs like pembrolizumab or nivolumab. Typically, immunotherapy boosts the immune response by targeting particular immune system proteins.

According to an early-phase clinical trial conducted by researchers from the National Cancer Institute’s Center for Cancer Research (CCR)^[4], two patients with metastatic cervical cancer had their tumours vanish completely following immunotherapy, known as adoptive cell transfer (ACT). A third patient's tumour shrank for a brief time after the procedure.

Prevention of cervical cancer

Cancer prevention is essential as it improves one’s overall health and, hopefully, reduces the risk of developing it by:

• HPV vaccination.

• Regular pap test and HPV test.

• Use condoms during sexual activity.

• Avoid smoking.

• Early vaccination at ages 9 to 14 years.

 

 

Cervical cancer screening

Cervical cancer screening involves using certain tests to find abnormalities or early indicators of cancer before symptoms appear.

The two primary screening methods include:

• The Pap test (pap smear) looks for precancers and abnormalities in the cervix cells that might become cervical cancer if left untreated. Sometimes, it can even identify non-cancerous conditions like infection or inflammation.

• The human papillomavirus test (HPV) detects cells for infection with high-risk HPV types that can cause cervical cancer.

 

 

Why is cervical cancer screening important?

Cervical cancer screening is an effective tool for identifying precancerous changes in the cells early on. When these changes are detected, there is a chance to take action before cancer manifests. Early-stage cervical cancer has a better chance of full recovery and is frequently easier to treat.

Cervical cancer vaccine

The cervical cancer vaccine refers to the human papillomavirus (HPV) vaccine, intended to prevent infection and encourage the body's immune system to produce antibodies to combat HPV.

The most often administered HPV vaccinations are called quadrivalent and bivalent vaccines. 

The Centers for Disease Control and Prevention^[5] states that the HPV vaccination may be able to avert over 90% of malignancies linked to HPV.

The HPV vaccination is recommended for girls ages 11 to 12 and girls and women ages 13 to 26 who have not had the complete set of vaccinations. Girls as young as age nine can also receive the vaccination.

How do I check myself for cervical cancer?

Cervical screening tests are available to those aged 25 to 74. In addition, cervical screening participants can now choose to self-collect their cervical screening test sample.

A healthcare provider will assign you a private room and tell you rules to abide by. All that is required is to insert a swab a few centimetres into your vagina, followed by 20 to 30 seconds of rotation.

Beyond regular tests and screenings, be alert to any odd signs that may indicate cervical cancer, such as irregular vaginal bleeding, pelvic discomfort, pain during sex, or changes in vaginal discharge.

Insurance solutions for cervical cancer

Although preventive measures can be taken to reduce the risk of developing cervical cancer, there is no guaranteed way to ensure safety from this disease. Thus, it’s essential to prepare or the unfortunate.

Prudential’s PRULady, is a critical illness insurance for women that provides coverage for gender-specific illnesses, fertility care, wellness care, recovery, pregnancy care, and baby care and provides cash rewards to celebrate siginificant life milestones.

If you are diagnosed with female carcinoma-in-situ, the payout will be 50% of the Basic Sum Assured. You will get 100% of the Basic Sum Assured if the condition worsens and it is confirmed that you have been diagnosed with uterine cancer after 6 months from the diagnosis date of carcinoma-in-situ.

Additionally, PRULady offers Cash Rewards for Life Celebration Benefit from 10 Life Milestones, up to a maximum of 9% of the Basic Sum Assured.

Does insurance cover cervical cancer screening?

This will depend on your insurance provider, with some companies offering screening tests to prevent cancer. This promotes early detection in hopes of a better treatment outcome.

Conclusion

Women need to be proactive in their care, get immunised, and undergo routine examinations to maintain optimal reproductive health.

Besides understanding cervical cancer, being equipped with the knowledge of other female cancers, such as uterine cancer  and breast cancer, - its types, symptoms, stages, treatments, and recovery path is essential.

Check out Prudential's wide range of insurance solutions and financial products, such as Insurance for Young Adults | Investment-linked Life Insurance | Medical Insurance | Critical Illness Insurance | Insurance for Mother & Child

References

^[1] Cervical cancer. Available at https://www.who.int/news-room/fact-sheets/detail/cervical-cancer

^[2] Cervical Cancer: 2018 Revised International Federation of Gynecology and Obstetrics Staging System and the Role of Imaging. Available at https://pubmed.ncbi.nlm.nih.gov/32182097/

^[3] Cervical cancer. Available at https://www.who.int/health-topics/cervical-cancer#tab=tab_1

^[4] Immune-Based Treatment Shows Promise against Metastatic Cervical Cancer. Available at https://www.cancer.gov/news-events/cancer-currents-blog/2015/immunotherapy-cervical

^[5] HPV Vaccination: What Everyone Should Know. Available at https://www.cdc.gov/vaccines/vpd/hpv/public/index.html