CERVICAL CANCER is the most common gynecologic malignancy in the Philippines. It is also highly preventable, nonhereditary, and curable if treated early.
Nearly all (99.7%) of cervical cancer is caused by the human papillomavirus (HPV). There are 100 types of HPV, a common sexually transmitted infection. Thirty of these can affect the genitals; 14 can lead to cervical cancer.
Because HPV is transmitted during intercourse, safe sex can prevent this type of cancer, according to Percida Soriano-Cocos, an obstetrician-gynecologist (OB-GYN) at the Adventist Medical Center Manila.
“Those who are in a mutually monogamous relationship have a very low risk for this cancer,” Dr. Cocos said. “For those who are not mutually monogamous, safe sex — which includes the use of condoms — is advised.”
Strengthening the immune system through a healthy diet, exercise, and adequate sleep is also advisable, as a robust immune system wards off HPV infection.
Dr. Cocos said that girls and women aged 9–26 years can get the HPV vaccine, of which there are three types: the 9-valent HPV vaccine (Gardasil 9, 9vHPV), the quadrivalent HPV vaccine (Gardasil, 4vHPV), and the bivalent HPV vaccine (Cervarix, 2vHPV).
All three HPV vaccines protect against HPV types 16 and 18, which cause most HPV cancers.
Only two doses are needed if the first dose was given before the age of 15, per the US Centers for Disease Control and Prevention (CDC). Teens and young adults who start the series later, at ages 15 through 26 years, need three doses.
Vaccination is not recommended for everyone older than 26 since more people in this age range have already been exposed to HPV, according to the CDC. Adults aged 27 through 45 years can discuss getting vaccinated against HPV with their doctor to assess the benefits, the CDC added.
“Immune protection from vaccination is higher if given before one’s HPV exposure,” Dr. Cocos told the webinar audience. “It can be given until a woman is 45 years … If a woman is above 45 years and is still sexually active, she can ask her doctor [about it].”
Cervical cancer is the second most frequent cancer in the Philippines and the second most frequent cancer among women between 15 and 44 years of age. Worldwide, cervical cancer is the fourth most common cancer among this population. The World Health Organization reported that about 90% of the total number of new cases and deaths in 2020 occurred in low- and middle-income countries.
Telltale signs include foul vaginal discharge and bleeding after intercourse, or contact bleeding.
“If you have contact bleeding, even if you don’t have pain, [get yourself checked],” said Dr. Cocos.
A pap smear, which detects precancerous cells, and the HPV test, which looks for HPV that can cause cell changes, can help prevent cervical cancer or find it early. The former can be done starting at age 21; the latter, starting at age 30.
The five-year survival rate of those whose cancer is detected at stage 0 (or when the precancerous cells are still in a limited area) is 100%. At stage 4, when the disease has already invaded the bladder or rectum, or has metastasized, that same survival rate decreases to 5%.
Women who get screened early or have regular check-ups with their OB-GYN need not reach this stage, Dr. Cocos said. — Patricia B. Mirasol