Procedures such as an LBC test significantly enhances the clinical reliability by minimising the need for multiple samples
By: Dr. Sachin Kolte
In India, cervical cancer accounts for almost 14% of all female cancer cases. In 2018 alone, almost 0.1 million new cases of cervical cancer were reported along with more than 60,000 women losing their battle to one of the most treatable cancers. Treatment of cervical cancer is stage-specific and depends on the patient’s age, overall health, desire to preserve fertility, the clinician’s expertise, and accessibility to resources. Due to lack of accessible cervical cancer screening in the country, late detection, lack of access to affordable and quality care and a paucity of uniform treatment protocols for various stages of cervical cancer in India, patient numbers continue to soar.
Screening needs to be boosted
“The first time I got cervical cancer screening done was when I was 26. It was a part of the regular annual check-up as suggested by my gynaecologist. When the test resulted positive, I was shocked. It was then I realised how important it is to get cervical cancer screening done even when you do not have any symptoms. It is a silent disease and just because you don’t see the signs, it doesn’t mean you are not at risk. The only way to find out is through screening,” says 56-year-old Alice.
Cervical cancer is a sexually transmitted disease, which can be protected through safe sex practises. Women aged 25 to 64 are advised to have a cervical screening test, also known as a smear test, within the period recommended for their age. Basically, a cervical screening test is a technique of detecting abnormal cells on the entrance to the womb from the vagina called the cervix. This means, cervical screening isn’t a test for cancer, it is a test to check the health of the cells of the cervix.
New developments – Liquid based cytology
While pap smear seems to be the most common test for cervical cancer, it does not guarantee a reliable answer to cellular abnormalities. Not only is the pap smear process limiting, but it also requires multiple samples to screen for different subsets of cervical cancer.
However, the good news is, detecting strains of malignancies in the early stage has become possible due to developments in the field of oncology. Take for instance, Liquid based cytology (LBC) is a new technique for collecting any cellular abnormalities, pre-cancerous lesions, atypical cells and all other cytological samples in the cervix. By collecting cells from the surface of the cervix, a doctor can examine the presence of any malignancy.
Unlike a pap smear test, advanced screening procedures such as an LBC test significantly enhances the clinical reliability by minimising the need for multiple samples. For instance, the same sample, once collected, can be reused in future tests and ancillary testing like HPV screening. As LBC procedure works on the principle of cell enrichment technique used in LBC tests, the cellular abnormalities can be observed more clearly and addressed more efficiently.
With conventional cytology, or microscopic investigation, a smear taker takes a sample that is applied directly to a slide. With LBC, the slide is prepared semi-automatically at the laboratory and samples are collected in liquid vials. Potentially the advantages of LBC include a reduction in the number of inadequate slides, increased sensitivity of the test and increased productivity of smear readers
Nip it in the bud
As cancer is a progressive disease, it must be detected in the initial (precancerous) stage itself. Taking cognizance of disease symptoms such as — abnormal vaginal discharge, pain in the pelvic region, pain during intercourse and abnormal menstrual cycle – women must consult a specialist at the earliest. In fact, detecting symptoms of cervical cancer in the precancerous stage leads to a 93% survival rate.
As one of the most easily manageable cancers, unfortunately, the awareness around the disease remain low. This is the main reason why most women in their 50s are diagnosed with end-stage cervical cancer. By building an environment that promotes early screening of women beginning from puberty, the government can save many precious lives. It is important to keep in mind that cervical cancer is preventable with vaccination. The good news is India saw a drop of over 21% in its cervical cancer cases, between 2012 and 2018. Even still, regular screening programmes, affordable healthcare, and an awareness programme that tackles the stigma around such screenings are crucial to further fight cervical cancer in the country.
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