A Preventable Cancer
Cervical cancer is one of the few cancers where we have a clear, proven prevention strategy. Human papillomavirus (HPV) — particularly strains 16 and 18 — is responsible for approximately 70% of all cervical cancers. HPV is so common that most sexually active adults will be infected at some point; in most cases the immune system clears it without any consequence. But in some women, persistent HPV infection causes cellular changes in the cervix that, over years to decades, can develop into cancer.
The good news: we can interrupt this process at multiple points.
HPV Vaccination: Who Should Get It?
The HPV vaccine is most effective when given before sexual debut, as it prevents infection rather than treating an existing one. Current Indian Academy of Pediatrics guidelines recommend vaccination at age 9–14, with a 2-dose schedule. The 9-valent vaccine (Gardasil-9) protects against nine HPV strains including 16 and 18, which together cause 70% of cervical cancers.
However, vaccination also benefits women up to age 45 who have not yet been exposed to the strains covered by the vaccine. If you have not been vaccinated, it is worth discussing with your gynaecologist regardless of your age.
Pap Smear Screening: The Cornerstone of Early Detection
The Pap smear collects cells from the transformation zone of the cervix and examines them for precancerous changes. When precancerous cells are found and treated, cervical cancer is prevented before it starts.
Current recommendations:
- Begin screening at age 21, or within 3 years of first sexual activity
- Pap smear alone every 3 years (ages 21–29)
- Co-testing — Pap smear plus HPV DNA test — every 5 years (ages 30–65)
- Continue screening even after HPV vaccination
Understanding Abnormal Pap Smear Results
An abnormal result does not mean cancer. Most abnormalities represent low-grade cellular changes the body resolves on its own. High-grade changes (CIN2–3 / HSIL) require colposcopy and treatment — typically a loop excision (LEEP) or cone biopsy, performed under local anaesthesia as an outpatient procedure.
Symptoms of Cervical Cancer to Watch For
- Post-coital bleeding (bleeding after intercourse)
- Intermenstrual bleeding (spotting between periods)
- Post-menopausal bleeding
- Unusual vaginal discharge (watery, mucoid, or blood-tinged)
- Pelvic pain (in more advanced disease)
Any of these symptoms should prompt an urgent gynaecological assessment. Post-coital bleeding is the most specific early symptom of cervical cancer and warrants investigation — do not assume it is normal.
Dr. Nishtha Tripathi Patel is an ESGO-certified gynaecological oncologist in Ahmedabad. Consultations available at Sterling Hospitals, KD Hospital, and Welcare Speciality Hospital. Call +91 76988 00333.