Cervical cancer is highly preventable. Dr. Sanjana L at Health Nest (HSR Layout) and Raghava Hospital (Attibele) explains the importance of Pap smears, HPV testing, and the HPV vaccine.
Cervical Cancer in India — A Preventable Tragedy
Cervical cancer is the second most common cancer in Indian women, accounting for approximately 1.23 lakh (123,000) new cases and over 77,000 deaths annually in India. These numbers are staggering — but what makes them even more heartbreaking is that cervical cancer is one of the most preventable and treatable cancers when detected early through regular screening.
At Health Nest (HSR Layout) and Raghava Hospital (Attibele), Bangalore, Dr. Sanjana L is passionate about preventive women's healthcare. She strongly advocates for routine cervical screening and actively counsels patients about the HPV vaccine.
What Causes Cervical Cancer?
Nearly all cervical cancers are caused by persistent infection with high-risk strains of the Human Papillomavirus (HPV). HPV is an extremely common sexually transmitted infection — most sexually active people will be exposed to HPV at some point in their lives. In most cases, the immune system clears the infection within 1-2 years. However, in some women, certain high-risk HPV strains (particularly HPV 16 and HPV 18) persist and can cause abnormal cell changes in the cervix that, if left undetected and untreated, may progress to cervical cancer over 10-15 years.
Risk Factors for Cervical Cancer
- Persistent HPV infection (especially HPV 16 and 18)
- Lack of regular cervical screening
- Smoking (weakens the immune system's ability to clear HPV)
- Weakened immune system (HIV, immunosuppressive medications)
- Long-term use of oral contraceptive pills (more than 5 years — though the benefit usually outweighs the risk)
- Early onset of sexual activity
- Multiple sexual partners (increases HPV exposure)
- History of sexually transmitted infections
- Family history of cervical cancer
Cervical Cancer Screening Methods
1. Pap Smear (Cervical Cytology)
The Pap smear has been the cornerstone of cervical cancer screening for decades. It is a simple, quick procedure performed during a routine gynaecological examination.
How it works:
- A small brush or spatula is used to gently collect cells from the surface of the cervix
- The cells are sent to a laboratory for examination under a microscope
- The pathologist looks for abnormal cells that could be pre-cancerous or cancerous
Who should get a Pap smear:
- All women aged 25-65 years
- Earlier if sexually active before age 25 (start 3 years after first sexual intercourse)
- Every 3 years if normal results
What results mean:
- Normal (NILM): No abnormal cells detected. Repeat in 3 years.
- ASCUS (Atypical Squamous Cells of Undetermined Significance): Mildly abnormal cells. Usually requires HPV testing or repeat Pap in 12 months.
- LSIL (Low-grade Squamous Intraepithelial Lesion): Mild cell changes, often caused by HPV. Usually monitored; most resolve on their own.
- HSIL (High-grade Squamous Intraepithelial Lesion): More significant cell changes that require further evaluation and treatment (colposcopy and biopsy).
2. HPV DNA Test
The HPV test detects the presence of high-risk HPV strains in cervical cells. It is more sensitive than the Pap smear and can identify women at risk of developing cervical cancer even before cell changes occur.
Screening recommendations:
- HPV test can be used as the primary screening tool for women aged 30 and above
- Combined with a Pap smear (co-testing) for the most comprehensive screening
- If both Pap and HPV are normal, repeat in 5 years
3. VIA (Visual Inspection with Acetic Acid)
A simpler, low-cost screening method where the cervix is examined after applying acetic acid (vinegar). Abnormal areas turn white. VIA is useful in resource-limited settings but is less sensitive than Pap smear or HPV testing.
The HPV Vaccine — Your Best Protection
The HPV vaccine is one of the greatest advances in cancer prevention. It protects against the HPV strains most commonly responsible for cervical cancer, genital warts, and other HPV-related cancers.
Available HPV Vaccines in India
| Vaccine | HPV Strains Covered | Doses |
|---|---|---|
| Cervavac (India's own) | HPV 6, 11, 16, 18 | 2-3 doses based on age |
| Gardasil 4 | HPV 6, 11, 16, 18 | 2-3 doses based on age |
| Gardasil 9 | HPV 6, 11, 16, 18, 31, 33, 45, 52, 58 | 2-3 doses based on age |
| Cervarix | HPV 16, 18 | 2-3 doses based on age |
Who Should Get the HPV Vaccine?
- Girls and boys aged 9-14: Ideally before exposure to HPV (before sexual activity begins). Two doses are sufficient at this age.
- Women and men aged 15-26: Three doses recommended. Still highly beneficial.
- Women aged 27-45: Vaccination can still provide protection, especially if not previously exposed to the vaccine-covered HPV strains. Dr. Sanjana can advise based on your individual risk.
Key Facts About the HPV Vaccine
- The vaccine is preventive, not therapeutic — it protects against new infections but does not treat existing HPV
- It is safe, well-studied, and recommended by the WHO, Indian Academy of Pediatrics, and FOGSI
- Side effects are mild: soreness at the injection site, mild fever, or headache
- Even vaccinated women should continue with regular cervical screening
If Your Screening Is Abnormal — What Happens Next?
If your Pap smear or HPV test shows abnormal results, Dr. Sanjana will guide you through the next steps:
Colposcopy
A detailed examination of the cervix using a colposcope (a magnifying instrument). Abnormal areas are identified and biopsied if needed.
Cervical Biopsy
A small tissue sample is taken from the cervix for laboratory examination to determine the severity of cell changes.
Treatment of Precancerous Changes
- LEEP (Loop Electrosurgical Excision Procedure): A thin wire loop removes abnormal cervical tissue. Done under local anaesthesia.
- Cryotherapy: Freezing abnormal cells
- Cone biopsy: Surgical removal of a cone-shaped section of the cervix
When precancerous changes are detected and treated early, the progression to cervical cancer is prevented in nearly all cases.
Frequently Asked Questions
Is a Pap smear painful?
Most women experience only mild, brief discomfort — similar to a pinch. The procedure takes less than 5 minutes. Dr. Sanjana uses gentle technique and explains every step.
Can I get the HPV vaccine if I am already sexually active?
Yes. The vaccine is still beneficial as you may not have been exposed to all the HPV strains it covers. Discuss with Dr. Sanjana to determine if vaccination is right for you.
Do I need screening if I have had the HPV vaccine?
Yes. The vaccine does not cover all high-risk HPV strains. Regular Pap smears and HPV testing remain important even for vaccinated women.
Is cervical cancer hereditary?
Cervical cancer is not directly hereditary, but having a family member with cervical cancer may slightly increase your risk. The primary cause is HPV infection.
At what age can I stop cervical screening?
Women over 65 can generally stop screening if they have had consistently normal results for the previous 10 years. Discuss with Dr. Sanjana.
Get Screened at Health Nest, HSR Layout
Dr. Sanjana L provides comprehensive cervical cancer screening — Pap smear, HPV testing, colposcopy, and HPV vaccination — in a comfortable, private setting at Health Nest, HSR Layout, Bangalore.
Do not wait for symptoms. Cervical cancer in its early and precancerous stages has no symptoms. Screening is the only way to catch it early.
Health Nest (HSR Layout, near Agara Lake) and Raghava Hospital (Attibele, opposite Syndicate Bank). Serving Koramangala, BTM Layout, Sarjapura, Electronic City, and all of South Bangalore.
Book your cervical screening appointment today.
Dr. Sanjana L
MBBS MS ( OBG) Gold Medalist FRM ( RGUHS) FMAS
Gynaecologist & Obstetrician at Health Nest, HSR Layout & Raghava Hospital, Attibele, Bangalore
Dr. Sanjana L has over 10 years of experience in obstetrics and gynaecology. She is known for her compassionate, patient-centred approach and consults in English, Hindi, Kannada, and Telugu. She serves patients from HSR Layout, Attibele, Sarjapura, Electronic City, Koramangala, BTM Layout, Chandapura, and Hosur.