Protect The Next Generation ….Indu Shahani
Lets educate Indian women about how to combat cervical cancer
Lets educate Indian women about how to combat cervical cancer
My career has been spent on the campuses of schools and colleges.Over four decades,the most heart-warming change ive noticed is the increase in the population of girls in Indian classrooms.Todays young women have better opportunities,greater academic accomplishment and,at least in our big cities and urban milieu,greater social autonomy than ever before.
In the past decade,as Indias economy has grown and as the media and marketing revolutions have transformed our society,urban women are living a different lifestyle.As a teacher,i see this in schools and colleges every day.It is evident in the way young people eat,meet,interact,entertain and relax.
Some tend to be judgemental about these changes and see them as necessarily bad;im not so sure.Evolution is inevitable.We should welcome it and adapt to it,rather than rail against it.Unfortunately,not enough effort is being made in this direction.
Take public health,particularly the health of women.Lifestyle changes,the growth of a snack food culture,tobacco use,greater sexual freedoms and career women postponing pregnancy decisions: all of these have profound health implications.Are we preparing our young women for these As an educationist,i can never run away from that fundamental question.
Why am i focussed on health implications for women After all,new lifestyles and modes of living and working affect men equally,and surely have health consequences for them as well.True,but two caveats need to be entered here.First,there are some diseases i refer specifically to two cancers,that of the breast and that of the cervix that are exclusive to women.Second,however much we may have closed the gender gap,the fact is that as a society we spend much less on the care and treatment of ill women than of men.Regrettably,this distinction is made in the mansions of Malabar Hill as much as in the slums of Dharavi.
Ive worked with breast cancer victims and awareness groups and much more is known about this disease today than even a decade ago.Its time to focus on cervical cancer prevention and treatment too.This is one of the rare cancers that is preventable and curable.Yet it afflicts 1,34,000 additional women in India each year (2008 figures).Some 2,75,000 women die of cervical cancer in the world every year.One of every four does so in India.One-third of women who register for cancer diagnosis in Indian hospitals suffer from cervical cancer.
The most common cause of cervical cancer is the human papillomavirus (HPV).The scientist who made that connection won the Nobel prize for medicine a few years ago.HPV is transmitted during sexual contact,particularly when the womans immune system has been weakened by,for instance,smoking.Nevertheless,we hardly tell our young women about it.
Puberty brings about a kaleidoscope of changes in a girls persona physical,physiological and psychological.Puberty is therefore crucial to cervical cancer spread or,if we get it right,prevention.Experimenting with unprotected sex at this stage can enhance the risk of contracting HPV.A womans cervix is underdeveloped at this age and has an immature epithelium (the top layer of tissue on the skin).This makes chances of infection higher.
Routine screening of the cervix through tests such as the pap smear is advisable for sexually active women of 30 years or older.It can offer early detection of cervical cancer.This test needs to be repeated every three years,as per protocols in most developed countries.
The remarkable aspect of modern medical science is that we can arrest and combat the cancer (or more accurately,precancer ) at several points.More recently,the HPV test is available to detect the presence of infection with high risk HPV types.Even if the HPV test is positive,it still does not mean the woman has cervical cancer;she just has an HPV infection.
Most HPV infections are temporary and the bodys immune system subdues the infection in due course.Only if the virus persists will there be higher chances of the infection causing cervical cancer cell abnormalities and,later,cervical cancer.As such,layered,multiple and regular screening is essential.It can lead to timely detection and treatment,and prevent death due to cancer of the cervix.
Cervical cancer can also be prevented by using vaccines.Medical professionals recommend vaccinating with the HPV vaccine prior to a womans first sexual encounter.A World Health Organisation position paper on HPV vaccination says: HPV vaccines are most efficacious in females who are naive to vaccine-related HPV types.The primary target population is likely to be girls within the age of nine or 10 years through 13 years.
HPV vaccines are in use in over 100 countries.They are endorsed by the Federation of Obstetric and Gynaecological Societies of India and the Indian Academy of Paediatrics.We should tell our daughters about them.Indeed,we should start a conversation about cervical cancer.The next generation needs to know,and needs to be protected.
The writer is the Sheriff of Mumbai and principal of H R College of Commerce and Economics.
* Let them be girls,uninterrupted