Did you know that the number of women who are diagnosed with cervical cancer each year is a staggering 122,844? Of these, 67,477 women pass away from this disease. In women, in the age group of 15 to 44 years, cervical cancer is the second most common cancer diagnosed. However, the incidence of this disease peaks in the age group of 55 to 59. The good news is that cervical cancer is preventable if it is detected in time with a reliable cervical cancer screening test. But before we get to that, let’s understand more about cervical cancer.

What is cervical cancer?

When the cells in the human body are damaged or they become worn out, new cells are created to take their place. Our body is made up of trillions of such cells that are continuously being replaced by new ones. However, when the normal process of cell division is impaired, damaged cells grow and spread.

Cancer is a disease where some of the cells in your body begin to grow out of control and they spread to other parts as well. The disease can start anywhere and can also spread anywhere and begin to grow there.

Now, the cervix is that part of your body that connects your vagina to the upper part of the uterus. The tissue of the cervix is made up of innumerable cells. When healthy cells begin to grow without control, they can turn cancerous. When the cancer starts in the cervix, it is called cervical cancer and specific tests for screening of cervical cancer help identify the change quickly.

How and where does cervical cancer typically begin?

The cervix has two parts:

• Endocervix: This is the opening that channels into the upper uterus where the foetus develops during pregnancy.
• Exocervix: Also known as ectocervix, which is the exterior part of the cervix.

These two parts are covered by different kinds of cells, as listed below.

• Glandular: These cells cover the endocervix.
• Squamous: These cells cover the exocervix.

Where these two regions meet, and the two different types of cells overlap, it is known as the transformation zone in the cervix. Usually, cervical cancer begins right here in the transformation zone. This zone may keep changing as you age or after you give birth.

Two main types of cervical cancer

Squamous cell cancer and adenocarcinoma are the two types of cervical cancer that you can get.

• Squamous cell cancer: This is the most common type of cervical cancer with about 80 to 90% of cancers being identified as squamous cell cancers. This cancer develops when the squamous cells are over produced in the topmost layer of the skin called the epidermis. You may have heard of skin cancers arising from over exposure to the sun. This is one of the major ways in which you can develop squamous cell skin cancer. But this cancer also arises in the sensitive inner lining of organs where you have mucous membranes.
• Adenocarcinoma: This type of cancer grows in the glands that you find lining various organs. This is the most common type of cancer diagnosed. It develops in the cells of the glands, but it can grow well beyond the glands and affect various other parts of your body if left unchecked. About 10 to 20% of cervical cancers are adenocarcinomas.
• Mixed carcinomas: As the name suggests, this is a type of cancer that exhibits the features of both the above kinds. These are comparatively very rare and usually one of the other two variants are found. Other types of cancers may also develop in the cervix, though very rarely.

Understanding pre-cancerous changes and cancer

In the transformation zone of the cervix, the cells do not turn cancerous overnight. Some changes may take place gradually, making the cells abnormal. These changes can be identified by doctors with the help of screening for cervical cancer tests. It is important to note that all pre-cancerous cells do not turn cancerous. In some women, these cells disappear on their own. But in others, these can turn into cervical cancer of the invasive kind that may have fatal outcomes. This is the reason why it is critical to get cervical cancer screening tests done regularly, so that pre-cancerous cells can be identified early and treated/monitored and prevented from turning cancerous. Almost all cervical cancer cases can be prevented by treating pre-cancerous cells effectively and in time. Timely cervical cancer screening can literally save your life.

Factors that cause cancer

Cancer occurs when your genes change in certain ways. This happens because of three main reasons:

• Your parents had it and you have ‘inherited’ it from them
• Something went wrong when the cell division took place in your body
• You were exposed to something (like the sun’s UV rays causing skin cancer) that damaged your DNA

Cervical cancer is most often caused by the human papillomavirus or HPV. This is a sexually transmitted infection that causes this type of cancer. The virus is usually dealt with by the body’s own immune system. However, in some women, the virus remains active for years, and slowly, the healthy cells in the cervix become cancerous.

Keep in mind that the virus spreads from person to person via intimate skin to skin contact. Typically, sexual intercourse with several partners puts one at great risk of an HPV infection that may eventually lead to cervical cancer. High level risk also arises in those who become sexually active at a very young age and in those whose sexual partner is a high-risk individual for HPV infection. If you fall in the high-risk category, periodic cervical cancer screening test is a must for you to prevent this dreaded disease.

What are the symptoms of cervical cancer to watch out for?

This is where the problem arises. When cervical cancer is in the nascent stage, it may have no symptoms or signs at all. It might be impossible to know that changes are taking place in the cervix.

Symptoms begin to appear when the cancer progresses, and they worsen over time. The severity and nature of symptoms varies in line with the organs and the extent to which the cancer has affected your body.

The most common symptoms that you should watch out for, are:

• Bloody spots in between periods or mild bleeding after periods have ended
• Bleeding after you have gone through menopause
• Periods that are longer than usual and where bleeding is much heavier than usual
• Constant pain in the pelvic region or lower back
• Bleeding that follows sexual intercourse
• Bleeding that follows a pelvic exam or douching
• Painful sexual intercourse
• Vaginal discharge that seems unusually heavy
• Foul odour from vaginal discharge

If you have been experiencing any of these symptoms, make a note of them, and note down how long you have been experiencing them. These notes, along with the screening test for cervical cancer will help your physician to derive the right information they need to decide how to proceed with the treatment.

Prevention of cervical cancer

Your best shot at being cancer-free is going for cervical cancer screening, meaning that with the right kind of screening, you can identify precancerous development in your cervix, and address it quickly before it has a chance to become cancerous. The common methods of cancer screening are the Pap smear test and the HPV test. For either, a tool is used to scrape cells off the walls of your cervix and then they are tested. This can show up precancerous cell growth.

There are HPV vaccines available too that can help young adults ward off the risks of cervical cancer. However, you must remember that these only prevent the infection from the human papilloma virus. They cannot help you if you are already infected with the HPV. Ideally, the HPV vaccine should be taken before an individual becomes sexually active. Even for those who have had the HPV vaccine, regular screening test for cervical cancer can be very helpful because vaccines are not 100% fool proof.

There is a third screening test known as the VIA inspection cervical cancer screening. VIA stands for Visual Inspection with Acetic Acid. A dilute solution of vinegar is coated onto the cervix during this screening. The healthcare professional carefully examines the cervix for abnormalities that appear white due to the application of vinegar. This is a relatively simple test requiring only a few equipment, but the expertise of the professional needs to be top-notch to identify the patches correctly.

According to expert cervical cancer screening guidelines, a PAP test every three years, followed by HPV plus Pap testing is immensely helpful. If any anomalies show up in these tests, you will need to undergo further testing using more detailed methods.

Colposcopy as the gold standard for cervical cancer screening

Experts maintain that colposcopy is the best way to detect cancer of the cervix. An HPV test is the primary test, but if it shows an abnormality, further testing is done via colposcopy. Where HPV testing is not available, the colposcopy screening method of cervical cancer can be done every three years.

Typically, in colposcopy, the doctor examines the vagina using a bright light after a speculum is used to hold open the walls of the vagina. The cervix and vagina are swabbed to clear the mucous and then examined. However, if any suspicious areas are found, a tissue sample is collected using a biopsy instrument. This makes the conventional colposcopy an invasive and somewhat painful process. In contrast, the digital colposcopy or imaging-based colposcopy is non-invasive and effective in getting the screening done with complete accuracy.

AI powered colposcopy

The colposcopy screening test for cervical cancer is believed to be the most accurate method for identifying the disease in its early stages. However, the conventional method, which involves a manual examination and extraction of tissues, has its drawbacks.

• Colposcopes are quite expensive and unwieldy in terms of size to manoeuvre easily.
• A health practitioner needs a lot of experience to be able to spot anomalies and determine where to collect the sample tissue from.
• The test is invasive and painful to some extent.

The good news is that digital imaging-based AI powered colposcopy addresses all these shortcomings and delivers accurate results that make the cancer screening process efficient, quick and painless.

The AI powered screening system can help the technician to identify the right sites. This means that the patient does not run the risk of a possible cancer being undiagnosed because of an inexperienced technician examining them. The human error factor is thus eliminated entirely.

Also, AI powered testing brings world-class screening tests to locations where there is a dearth of expert technicians or healthcare professionals who have the expertise to do the screening manually. Plus, this makes the screening test quick, painless and efficient. In short, Ai powered digital imaging-based colposcopy is the best option for you.

The best cervical cancer screening in India using digital colposcopy

AI-based imaging colposcopy screening test for cervical cancer is the best and simplest way to prevent this dreaded disease. This world-class technology is now available in India, thanks to NURA AI Health Screening Centre, which combines the prowess of Dr Kutty’s healthcare with the cutting-edge Fujifilm imaging technology.

The avant-garde technology allows NURA to carry out the most efficient form of testing with minimal doses of radiation. The tests, powered by AI, give extremely accurate results as well. Expert technicians guide you through the entire process, so you can undergo your testing with no anxiety whatsoever and the safe radiation levels mean that periodic screening does not expose you to unhealthy doses of radiation either. With a medical centre that is designed to make the screening/testing process simple and quick for you, and with staff trained to support and help you at every stage, cervical cancer screening in India is simple and effective at NURA.