Cervical Cancer: Symptoms, HPV Vaccine and Screening

Cervical cancer is one of the most preventable cancers there is, yet it remains the second most common cancer in Pakistani women after breast cancer. It grows slowly, over many years, and in the early stages it usually causes no symptoms at all. That is why prevention depends on two things you can do while you feel perfectly well: the HPV vaccine and regular screening.

What causes cervical cancer?

Nearly all cervical cancers are caused by long-lasting infection with certain types of human papillomavirus (HPV), a very common virus passed on through intimate skin-to-skin contact. Most HPV infections clear by themselves within a year or two. In a small number of women the virus stays and slowly changes cells in the cervix, which is the lower end of the womb. If these changes are not found and treated, they can turn into cancer after 10 to 20 years.

Cervical cancer symptoms

Early cervical cancer and the changes before it usually have no symptoms. As it grows, signs may include:

• Bleeding between periods
• Bleeding after intercourse
• Bleeding after menopause
• Heavier or longer periods than usual
• Unusual vaginal discharge that may be watery, bloody or foul-smelling
• Pain in the pelvis or during intercourse

In advanced disease there can also be back pain, leg swelling, pain or blood when passing urine or stool, weight loss and tiredness. These symptoms are not always cancer, since infections and hormonal changes can cause them, but please do not ignore them or feel embarrassed. Any bleeding after intercourse or menopause should be checked.

Who is at higher risk?

• Women who have never been screened, or who are screened rarely
• Persistent infection with high-risk HPV types
• Smoking
• A weakened immune system, for example with HIV
• Many pregnancies, and long-term use of birth control pills
• Early marriage and early first pregnancy
• Other genital infections

Prevention 1: the HPV vaccine

The HPV vaccine protects against the virus types that cause most cervical cancers. It works best when given to girls aged 9 to 14, usually in one or two doses, before any exposure to the virus, and it can still help older girls and women up to the age your doctor advises. It has an excellent safety record. Ask your paediatrician, gynaecologist or the national immunisation programme about HPV vaccination for your daughters. Vaccinated women still need screening.

Prevention 2: screening

Screening finds abnormal cells long before they become cancer, when treatment is simple and almost always successful.

• HPV test: checks for the high-risk virus, and is the preferred test where available.
• Pap smear: collects cells from the cervix to look for changes under the microscope.
• VIA: a simple visual test using vinegar, available in some programmes.

Women are generally advised to start screening from about the age of 25 to 30 and continue every 3 to 5 years until about 65, depending on the test used and the results. The test takes a few minutes in a clinic and is not usually painful, although it can feel uncomfortable. Ask your gynaecologist what schedule suits you, even if you feel perfectly well. Screening does not depend on whether you have symptoms.

Other ways to lower your risk

• Do not smoke
• Use condoms, which lower but do not remove the chance of HPV spread
• Treat genital infections early
• Attend every follow-up if you have had an abnormal result

Diagnosis and treatment

If a screening test is abnormal, the doctor looks at the cervix with a magnifying instrument (colposcopy) and takes a small tissue sample. Pre-cancerous changes are removed or destroyed with simple procedures, often as a day case. Early cervical cancer is treated with surgery. More advanced cases are treated with radiotherapy combined with chemotherapy. Treatment is more effective, and often needs less extensive surgery, the earlier it starts.

When to see a doctor

• Bleeding after intercourse, between periods or after menopause
• Unusual, persistent or foul-smelling discharge
• Pelvic pain that does not settle
• You are 25 or older and have never had a screening test
• You have had an abnormal result and missed your follow-up

Key takeaways

• Cervical cancer is caused by HPV and is largely preventable.
• It usually has no early symptoms, so screening matters even when you feel well.
• The HPV vaccine given to young girls and regular screening are the best protection.
• Bleeding after intercourse or after menopause should always be checked.

Related medicines on Medimart

Cancer treatment is chosen and prescribed by your oncologist or gynaecologist. A commonly used supportive medicine during chemotherapy:

• Ondansetron: helps control nausea and vomiting from chemotherapy

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse cancer care medicines and supportive products on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please talk to your gynaecologist about screening and the HPV vaccine.