New Delhi: Cervical cancer is the second most common cancer in women in India. Every 8 minutes a woman in India is diagnosed with cervical cancer. But, unlike breast and ovarian cancer, cervical cancer is not caused by hormonal or genetic factors. It is because of the persistence of the sexually transmitted virus HPV(human papillomavirus) in the cervix repeatedly for many years. HPV infections that persist during menopause increase the risk of cervical cancer. (Journal of Infectious Diseases (2018)
In an interaction with News9Live, Dr. Astha Dayal, Director of Obstetrics and Gynecology, CK Birla Hospital Gurgaon, Robotic and Laparoscopic Surgeon, spoke about the link between cervical cancer and menopause.
There are two age groups where it is more commonly diagnosed- at 35 years and 55 years. The risk of cervical cancer, like most cancers, increases with age, and most women are diagnosed with it after menopause. A study published in the Journal of Clinical Oncology found that the risk of cervical cancer increases with age, with a significant increase in risk after age 50. Menopause is when a woman does not get her period for one year. The average age of menopause in India is 46 years. Menopause does not increase the risk of cervical cancer but with advancing age the risk of cancer increases.
Also, the use of hormone replacement therapy in postmenopausal women does not increase the risk of cervical cancer as mentioned in the Women’s Health Initiative study. Though there is no concrete evidence, hormonal changes during menopause may affect cervical cells and increase the risk of cancer according to a small study in the Journal of Steroid Biochemistry and Molecular Biology (2017).
Bleeding after menopause raises suspicion of cervical cancer. Cervical cancer can also cause pelvic pain, especially during menopause. A common finding of cervical cancer seen in menopause is the collection of pus in the uterus or pyometra, which is difficult to manage. Also, the treatment of cervical cancer -radical surgery, chemotherapy, and radiation therapy are difficult to tolerate in this age group.
Cervical cancer can be prevented by HPV vaccination preferably before the first sexual intercourse. The vaccines are recommended for women up to age 45 but may not be beneficial after menopause. Regular Pap tests and HPV screenings are important for early detection and prevention of cervical cancer. It is recommended every 5 years till the age of 65.
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