The primary risk factor for a Filipino woman to develop breast cancer is simply being female and living in the Philippines, according to the Philippine Breast Cancer Network (PBCN).
However, it is less commonly known that cervical cancer is the second most frequent type of cancer affecting Filipino women (between 15 and 44), following breast cancer. At least 12 Filipino women die daily from cervical cancer, the Department of Health (DOH) reports.
Data from the HPV Information Centre show the Philippines has approximately 39.6 million women aged 15 and older who are at risk of developing cervical cancer. Current estimates suggest that around 7,897 women are diagnosed with cervical cancer each year, with 4,052 succumbing to the disease annually.
Health professionals refer to cervical cancer as a “silent killer” due to the fact that it can take as long as a decade for symptoms to manifest, often by which time the disease has reached an advanced stage.
Cervical cancer is caused by various strains of the human papillomavirus (HPV). “Some types of HPV infection cause skin growths called warts and some types of HPV infection can cause cancer,” the Mayo Clinic states.
Although the majority of HPV infections do not result in cancer, specific strains of genital HPV are known to cause cancer in the cervix, the lower section of the uterus that connects to the vagina. Other forms of cancer have been associated with HPV infections, including those affecting the anus, penis, vagina, vulva, and the back of the throat.
“Women acquire that when they marry,” Dr. Margaret Stanley, professor of epithelial biology at Cambridge University, told Reuters. “It’s a sexually transmitted infection associated very much with early marriage, early childbearing, many children, lack of access to medical services.”
Even if a woman is in a monogamous relationship, she remains at a significant risk of developing cervical cancer if her partner engages with multiple other partners., according to Dr. Rebecca Singson.
The likelihood of cervical cancer increases with the number of partners a woman has, adds Dr. Singson, an obstetrician-gynecologist with a practice at the Makati Medical Center and the Asian Hospital.
While most women’s immune systems can combat HPV infections, these infections can lead to cancer over time. The risk is particularly elevated for women who smoke, those who have had multiple pregnancies, individuals who have used oral contraceptives for extended periods, and women who are HIV-positive.
In its early stages, cervical cancer typically has no specific symptoms. The American Cancer Society (ACS) says symptoms often do not begin until the cancer becomes larger and grows into nearby tissue.
When this happens, the most common cervical cancer symptoms are pain during sex, pain in the pelvic region and an unusual discharge from the vagina (the discharge may contain some blood and may occur between a woman’s periods or after menopause).
Abnormal vaginal bleeding is another symptom. This includes bleeding after vaginal sex, bleeding after menopause, bleeding and spotting between periods, or having (menstrual) periods that are longer or heavier than usual. Bleeding after douching may also occur.
The ACS says signs and symptoms of cervical cancer seen with more advanced disease can include swelling of the legs, problems urinating or having a bowel movement, and blood in the urine.
But there’s good news: Cervical cancer “is one of the easiest cancers to detect” and one of the most preventable and curable.
The most common method of testing for cervical cancer is traditionally the Pap smear (microscopic examination of cells taken from the cervix to detect cervical cancer).
“(Pap smear) had a major impact in bringing about a significant reduction in the incidence of deaths caused by cervical cancer in many countries,” Dr. Singson reported. “Applying this massive screening program some 50 years ago has resulted in a 50%-70% reduction of deaths from cervical cancer.”
But a recent critical review showed that a single Pap smear misses up to 50% of cervical cancer precursor lesions. That’s one out of two! “Knowing this makes us partly understand why cervical cancer continues to occur at such high incidence rates,” Dr. Singson stated.
But fortunately, there is now a HPV vaccine that can be used for males and females to protect against cervical cancer and genital warts.
“The vaccine works best if a person gets it before having the first sexual contact,” the Mayo Clinic states. “Once someone has HPV, the vaccine might not work as well or at all.”
The Mayo Clinic indicates that individuals who are younger exhibit a more favorable response to the vaccine compared to their older counterparts. When administered prior to the onset of an HPV infection, the vaccine is effective in preventing the majority of cervical cancer cases.
It is advised that children aged 11 and 12 receive two doses of the HPV vaccine, although it can be administered to children as young as 9 years old. The two-dose regimen is applicable until the age of 14, with the doses spaced at least five months apart. For adolescents and young adults aged 15 to 26 who initiate the vaccination series, a total of three doses is recommended.
