“Advanced methods of early detection can avoid cervical cancer”
Although cervical cancer is the fourth most common cancer in the female population worldwide, but women are lucky as there are advanced tools of early diagnosis through periodic screening tests, cervical smears, and HPV vaccine. ‘Hospitals’ magazine recently interviewed Dr. Toufic Eid, MD (MBBS) FRCOG Obstetrician and gynaecologist Consultant at Clemenceau Medical Center in Dubai to highlight the advanced tools of diagnosis and treatment at CMC Dubai.
How common is cervical cancer? What are the recent key facts about this disease?
Cervical cancer is the fourth most common cancer in the female population. In 2018, an estimated six hundred thousand women were diagnosed with cervical cancer worldwide and about half of them died from the disease.
The Pap smear test was originally invented by George Nicholas Papanicolaou in the 1920s. He was a Greek physician and a pioneer in cytopathology. Pap smears allowed us to detect the very early cellular changes in the cervix that may become cancer in the future. This secondary prevention method has significantly reduced cervical cancer over the years and it was a major breakthrough in fighting this terrible disease.
Recently, it was found that almost 99% of cervical cancer is due to an infection with high-risk HPV strains. Vaccines have been produced to combat the most common types of these viruses. It is estimated that global vaccination for HPV will reduce the risk of cervical cancer by more than 90%. Hence, primary prevention of cervical cancer is available by administering the vaccines.
The current secondary prevention, a combination of cervical cell liquid cytology and HPV testing, has replaced the classic pap smear with much greater accuracy. With early detection and effective management cervical cancer is preventable and curable. Recently, the World Health Organization (WHO) has launched the “cervical cancer elimination initiative” through the widespread use of primary and secondary prevention worldwide. The objective is to abolish cervical cancer by 2030.
Who is at risk?
It has been established that HPV infection is the main vector for cervical cancer, which is sexually transmitted. Other factors that are associated with it is having aids or reduced immunity, smoking, women who use birth control pills for many years, and having given birth to three or more children and having several sexual partners.
How can women prevent or lower the risk of cervical cancer?
Women can take steps to prevent cervical cancer by taking the HPV vaccine, practicing safe sex and quitting smoking.
In our practice, advanced stages of cervical cancer patients are very rare. We believe it is because the primary and the secondary prevention for cervical cancer are applied.
How is cervical cancer diagnosed and treated?
Women that develop abnormal cervical smear or have HPV high-risk positive results undergo colposcopy, which is an examination via a microscope that actually looks at the cervical cells. We can identify the abnormal areas in the cervix and treat them by freezing, cautery or resection. This is the treatment when we have abnormalities in the early pre-cancer stages. Patients that get to the cervical cancer stage, the preferred treatment is surgery and this will be usually in the form of radical hysterectomy, removing the uterus, cervix and the lymph nodes. There are other adjuvant therapies like radiation and chemotherapy that may also be incorporated.
What are the advanced treatments at Clemenceau Medical Center in Dubai?
Surgery was classically done as open surgery; but nowadays it’s done more and more laparoscopically. At Clemenceau Medical Center in Dubai, we use robot-assisted laparoscopic surgery to perform more precise resection and achieve better outcomes.