Cervical cancer is the cancer of the cervix – the lower and narrower part of the uterus that opens into the vagina. It is a slow-growing cancer that begins as an abnormal growth of cells of the cervix and can invade other parts of the body, including the vagina, bladder, liver, and lungs.
However, the slow growth of cervical cancer provides an opportunity for prevention, early detection, and treatment. It is often detected at a precancerous stage in young adults (20s – 30s).
Cancerous transformation is usually seen in women who are in their mid-50s.
How common is cervical cancer?
Cervical cancer is the fourth most common cancer among women worldwide.
An estimated 570,000 new cases of cervical cancer were seen globally in the year 2018, with 86 percent of these cases reported in the Caribbean, Latin America, Africa, and Asia. 90 percent of deaths from cervical cancer are reported
in low and middle-income countries.
A study conducted by The Caribbean Public Health Agency (CARPHA) showed that cervical cancer contributed up to 18.2 percent of cancer deaths in the Dutch and English-speaking countries of the Caribbean, such as Aruba, Curacao, St. Eustatius, Bahamas, Barbados, Cayman Islands, Jamaica, Montserrat, Puerto Rico, and Trinidad and Tobago.
According to CARPHA, nearly 50 percent of these cancer cases are preventable or treatable if diagnosed at an early stage.
A similar study conducted by CARPHA found that people in the Caribbean are 2-9 times more likely to die from cervical cancer compared to the US.
Research suggests this wide disparity is due to low socioeconomic status, lack of education, and poor access to cervical cancer screening in the Caribbean countries.
RISK FACTORS AND CAUSES
There are several known risk factors for cervical cancer:
- Human papillomavirus (HPV) infection: The majority of cervical cancer cases are seen in women who have had an HPV infection. HPV is not a single virus; it’s a group of more than 150 viruses. There are two broad categories of HPV:
- Low-risk HPV: The types of HPV that cause warts on and around genital organs and anus are known as low-risk because they rarely cause cancer.
- High-risk HPV: These viruses are called as high-risk because they contribute to the cancer of cervix, vagina, vulva, penis, anus, mouth, and throat. At least 15 types of HPV viruses are considered high-risk. Research has demonstrated a higher prevalence of high-risk HPV infection among African-Caribbean women when compared to other ethnicities.
Human papillomavirus spreads through skin-to-skin contact, although often through sexual activity. HPV infections are common, and most often have no symptoms. Usually, a healthy human body has enough immunity to fight back the infection.
However, sometimes this infection becomes chronic (long-lasting). Persistent infection with high-risk HPV can result in cervical cancer. This is why it is critical for women to start getting PAP tests by age 21, regardless of sexual activity, to detect HPV even when it does not have any symptoms.
- Chlamydia infection: Some studies have shown that women with chlamydia, a sexually-transmitted bacterial infection, are at a higher risk of developing cervical cancer.
- Oral contraceptives: Taking birth control pills for a long time increases the risk of cervical cancer. This risk is reduced once a woman stops taking birth control pills, and the risk returns to normal in approximately 10 years.
- Smoking: Women who smoke are twice as likely to get cervical cancer compared to non-smoking women. Tobacco contains many cancer-causing chemicals, some of which have been found in the cervical mucus of women diagnosed with cervical cancer.
- Diet: Research shows that women who eat fewer fruits and vegetables have a higher risk of developing cervical cancer.
- Obesity: Unhealthy weight gain is linked to the risk of cervical cancer development. As almost half the population in the Caribbean region is overweight, the risk of cervical cancer may be heightened in many African-Caribbean women.
- Multiple pregnancies: Women with a history of 3 or more full-term pregnancies are more likely to develop cervical cancer.
- Pregnancy at a young age: Having a pregnancy at a younger age, i.e., less than 17 years, increases the risk of cervical cancer by two times, compared to women who had their first pregnancy at 25 years or older.
- Weak immune system: A weakened immune system, which can be due to HIV or the use of immunosuppressive drugs, puts a woman at an increased risk of contracting HPV infection. The immune system is important in fighting cancer cells and limiting their spread. As immunity lowers, so does the body’s ability to destroy cancer cells.
- Socioeconomic status: Lack of access to healthcare services, especially preventive services, increases the risk of cancer that goes undetected for a longer time.