Cervical cancer screening and treatment

Worldwide, cervical cancer is the fourth most frequent cancer in women with an estimated 604 000 new cases in 2020 and an estimated of 342,000 deaths in 2020.

In Nepal also it the most common cancer in woman followed by breast cancer. The high mortality rate from cervical cancer globally (age standardized rate among women: 13.3/100 000 in 2020) could be reduced by effective interventions at different stages of life (3,4).

Cervical cancer is caused by a virus called- Human papilloma virus which is a sexually transmitted infection. The virus produces pre-cancer changes after many years of infection. The presence of virus and the pre-cancerous changes may be detected by various tests like HPV test, VIA test and Pap test. If woman has very good immunity, the body may eliminate the infection. However, there are many risk factors which promote cervical cancer; they are- HIV and other sexually transmitted infections, smoking, young age at birth of baby, giving multiple births etc.

Cervical cancer is prevented and treated by 3 level of strategies: – Primary prevention that includes HPV vaccination and proper education about the cervical cancer. Secondary prevention includes finding out HPV infection by HPV test, finding out cervical pre-cancerous lesion by VIA and PAP test and treatment of Thermal ablation. Tertiary prevention is done by referral to higher hospital for stage wise cancer treatment and other management.

Presently, MSI Nepal is providing primary prevention in the form of counselling and education. Now, HPV vaccine is not available here, but Government is providing it.

MSI Nepal is providing secondary prevention by providing HPV test that detects the virus, VIA test and Pap test that detect pre-cancerous test. HPV test is the most effective test to screen the risk of cervical cancer. This HPV test can detect the risk of cancer when the cancer is at the treatable stage. This test is done in woman from 30 to 65 years of age with the interval of 3 to 5 years depending upon her immunity and HIV status.

VIA and PAP test are also tests to detect pre-cancer lesions of cervix and they can be done in woman after 30 years of age. VIA is done at the interval of 1 year and Pap test after every 3 years if they come negative.