4. CANCER IS AN ABNORMAL AND AN EXCESSIVE GROWTH
OF CELLS WHICH ARE INCAPABLE OF DOING NORMAL
PHYSIOLOGICAL FUNCTION
Cancer is one of the most common diseases in the world:
1 in 4 deaths are due to cancer
Lung cancer is the most common cancer of men in world
but oral cancer in india
Breast cancer is the most common cancer of women but
cervical cancer in india
5. WHAT IS THE FEMALE RE
PRODUCTIVE TRACT ?
Vulva
Vagina
Cervix
Uterus
Fallopian tubes
Ovaries
6.
7. WHAT IS THE CERVIX ?
Opening of the
uterus (womb) into
the vagina
Cancer that affecting
Cervix is called
cervical cancer
12. How common is HPV?
Most men and women who have
had sex have been exposed to HPV
More than 75% of sexually active
women have been exposed to
HPV by age 18-22
13. If I have HPV, does it mean I will
get cancer?
NO!
In most cases HPV infection will
go away
Only women with persistent HPV
(where the virus does not go
away) are at risk for cervical
cancer
14. WHO IS AT RISK ?
EARLY MARRIAGE
YOUNG AGE AT FIRST PREGNANCY
SHORT INTEVAL BETWEEN PREGNANCY
POOR NUTRITION
POOR HYGEINE
WOMEN WITH STD
WOMEN WITH MULTIPLE SEXUAL PARTNER
HUSBAND WITH MULTIPLE SEXUAL PARTNER
SMOKING
15. How do I lower my risk?
Delay onset of sexual activity or remain
abstine
Do not smoke
Maintain a healthy diet and lifestyle
Practice safe sex. Condoms decrease the
chance of HPV exposure.
If eligible, consider getting the vaccine
that prevents most cervical cancers.
Get your Pap test and HPV testing as
recommended by your health care
provider.
16. SYMPTOMATOLOGY
ASYMPTOMATIC IN EARLY STAGES
BLEEDING
- POST COITAL
- INTERMENSTRUAL
- POST MENOPAUSAL
VAGINAL DISCHARGE
PAIN
RECTAL / URINARY SYMPTOM
17. WHAT CAUSES CERVICAL CANCER
?
The central cause of cervical cancer is
human papillomavirus or HPV:
HPV is transmitted through sexual contact
The HPV detected today could have been
acquired years ago
There are many different types of HPV that
can infect the cervix, vagina and vulva
‘Low-risk’ types may cause genital warts
‘High-risk’ types may cause precancer and cancer of the
cervix
• Most women who are infected with HPV will
never have any symptoms
18. CERVICAL CANCER IS THE CANCER
AFFECTING THE CERVIX OF THE UTERUS
2ND MOST COMMON CAUSE OF CANCER
DEATH IN THE WORLD AND 1ST CAUSE IS
THE BREAST CANCER
19. BUT IN THE DEVELOPING COUNTRIES
LIKE INDIA CERVICAL CANCER IS THE 1ST
CAUSE OF DEATH
20. Cancers that can be prevented or detected early by screening account for at
least 50% of all new cancer cases.
Cancer Facts & Figures 2009
Prevention & Early Detection
21. How we can prevent?
1.Vaccination
2.Regular pap smear screening
25. Prophylactic HPV Vaccine
Approved for Adolescent Girls
Vaccine HPV Types FDA approved Age range
Bivalent 16/18 2009 10-25* yrs
Quadrivalent 6/11/16/18 2006 9-26* yrs
*Routine vaccination for 11-12 year old females
26. Bivalent vaccine is called cervarix and a
quadrivalent vaccine guardasil
Three doses of guardasil given
intramuscular route at 0,2months and
6months
Single dose of guardasil cost about
2500rupees
29. CERVICAL CANCER – IDEAL FOR
SCREENING
CERVIX EASILY ACCESSIBLE FOR
EXAMINATION
LONG LATENT PRECANCEROUS PHASE
NATURAL HISTORY KNOWN
30. What is a Pap test?
Cells are collected from the surface of
your cervix by a doctor
These cells are then checked under a
microscope for any abnormalities
If abnormal (or precancerous) cells
are found, they can be treated before
they turn into cancer
Cervical cancer can be found in the
early stages, when it is easier to treat
31. PAP SMEAR
Papanicolaou test –
exfoliative cytology
test
cells collected are
from normally
shedding epithelium
.
◦ collected using
spatulas or brushes.
◦ Specimen is fixed,
stained and studied
for morphology under
microscope.
33. SpreadingSpread the material collected on the
spatula / cervix brush evenly over the
slide with a painting action and single
smooth stroke motion using both sides
35. 30-64 Years21-29 Years<21 Years
No routine
Pap smear
Pap Smear Guidelines: 2009
American College of Obstetrics and
Gynecology
Pap smear every 3
years
..if patient has had
3 or more normal
Pap results in a
row, no abnormal
test results in 10
years, and lacks
other risk factors.**History of cervical cancer or DES in utero, HIV positive,
immunosuppression, or other risk factors for acquiring
STDs.
Bi-annual
Pap smear
ACOG Practice Bulletin No. 109. Obstet Gynecol. 2009;114:1409-20.
≥65 Years
Consider
discontinuing Pap
smear at 65 or 70
years
..if patient has had
3 or more normal
Pap results in a
row, no abnormal
test results in 10
years, and lacks
other risk factors.*
36. Most cervical cancer can be
prevented
Cervical cancer is very rare in women
who get regular Pap tests
37. Creating messages to improve
women’s awareness:
Target messages
to reach women at
highest risk of
cervical cancer
(generally aged 30
- 50).
Involve women in
creating prevention
messages and
programs.
38. Barriers to women’s
participation in screening:
Little understanding of cervical cancer
Limited understanding of female reproductive organs
and associated diseases
Lack of access to services
Shame and fear of a vaginal exam
Fear of death from cancer
Lack of trust in health care system
Lack of community and family support
Concept of “preventive care” is foreign
39. Common misconceptions about
cervical cancer:
People often do not know that it is preventable
Belief that screening involves STI/HIV screening
Belief that a positive/abnormal Pap smear result
means a woman will die
Research found that:
◦ In South Africa and Kenya, women often think a
positive screening test means they have HIV
◦ In Mexico, women fear that treatment will leave
them sexually disabled
40. Places to reach women:
Local women’s groups
Community centers
Women’s workplaces
Places of worship
Health facilities
Women’s homes
Schools (parent’s
groups)
Markets
41.
42. What We Do – Save Lives
Helping peoplestay well
Byeducatingthem on stepstheycantaketoprevent cancerandfindit early
Helping peopleget well
Byproviding accurateandtimely informational,emotional,andpracticalsupport
services
Funding cancerresearch
Tofurtherunderstandits causes,determinehowbest toprevent it, anddiscovernew
waysto cureit.
Fighting backagainstcancer
Bysupportingthe indian CancerSocietyandthosein yourlife whoareaffectedby
cancer,youcanjoin us in creating aworldwithmorebirthdays!
43. We can End Cervical Cancer
Policy Makers
Vaccination
Screening