Women with mental illness twice at risk of developing cervical cancer; here's why
4 min read 26 Mar 2023, 01:12 PM ISTCervical cancer develops in a woman's cervix i.e. the entrance to the uterus from the vagina. As per WHO, almost 99 percent of all cervical cancer cases are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact.
PremiumA study published in The Lancet Public Health has stated women suffering from mental illness, neuropsychiatric disability, or substance addiction are less likely to undergo gynaecological screening tests for cervical cancer and are more than twice as likely to develop the disease.
The researchers from Karolinska Institute revealed their findings in The Lancet Public Health, emphasizing the necessity of engaging these women proactively as a preventative intervention against cervical cancer. According to the researchers, inequality of care is one of the major hurdles to this objective. "Our study identified a high-risk group that needs extra attention if we're to succeed in eliminating cervical cancer," says one of the study's first authors Kejia Hu, postdoc researcher at the Institute of Environmental Medicine at Karolinska Institute.
Cervical cancer develops in a woman's cervix i.e. the entrance to the uterus from the vagina. As per WHO, almost 99% of all cervical cancer cases are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact. Cervical cancer is the fourth most common cancer in women. In 2018, an estimated 570 000 women were diagnosed with cervical cancer worldwide and about 311 000 women died from the disease.
Coming back to Karolinska Institute, the researchers at stressed the importance of proactively approaching these women as a preventative measure against cervical cancer. The observational study included over four million women born between 1940 and 1995. In the women, the researchers compared women diagnosed by a specialist with mental illness, neuropsychiatric disability, or substance abuse with women without such diagnoses. Apart from this, they calculated the risk of cervical cancer and precancerous cervical lesions, including their participation in screening programs for cervical cancer.
"Our results suggest that women with these diagnoses participate more seldom in screening programs at the same time as they have a higher incidence of lesions in the cervix," one of the study's first authors Kejia Hu, Institute of Environmental Medicine at Karolinska said.
"We thus found that they have twice the risk of developing cervical cancer," said Hu.
As per the researchers, the greatest risk was observed for women with substance abuse. Women with mental illness should be made more aware of the need to undergo regular gynaecological screening, they said. "It would lower their risk of cancer," says one of the paper's authors Karin Sundström, senior researcher at the Department of Laboratory Medicine, Karolinska Institutet.
"Similarly, if healthcare professionals are more aware of the cancer risk in these patients, they can step up preventative measures and consider how these could be delivered to potentially under-served patients," said Sundström.
Stating the limitation to the observational study, the researchers did not have full data about other risk factors for cervical cancer such as smoking, hormonal contraceptives, and sexually transmitted diseases, it said.
Earlier in May 2020, WHO had approved a global strategy for eliminating cervical cancer as a women’s health problem. Part of the strategy is a requirement that 70 percent of women are screened for the disease at least once before age 35 and twice before age 45. According to the researchers, inequality of care is one of the major hurdles to this objective. "Our study identified a high-risk group that needs extra attention if we're to succeed in eliminating cervical cancer," said Hu.
Symptoms of Cervical Cancer
As per the National Cancer Institute, in the early stage, cervical cancer usually do not have have symptoms, it begins usually begin after the cancer has spread.
Symptoms of early-stage cervical cancer include:
vaginal bleeding after sex
vaginal bleeding after menopause
vaginal bleeding between periods or periods that are heavier or longer than normal
vaginal discharge that is watery and has a strong odor or that contains blood
pelvic pain or pain during sex
Symptoms in the advanced of cervical cancer include:
difficult or painful bowel movements or bleeding from the rectum when having a bowel movement
difficult or painful urination or blood in the urine
dull backache
swelling of the legs
pain in the abdomen
feeling tired
Cervical cancer in India
Last year, a latest Lancet on the disease showed that India accounts for the highest number of cervical cancer cases in Asia, followed by China. The research had revealed that out of the 40 percent of the total deaths from cervical cancer, 23 percent occurred in India, while 17 percent in China.
In February 2023, an estimate by estimate by AIIMS based on the data provided by the Indian Council of Medical Research (ICMR) said that India will see a surge in cancer cases in the coming years which can go upto 20 lakhs per year by 2026. He further stated, "13-14 lakh people are getting affected by the deadly disease each year and the figure could go in excess of 20 lakhs by the year 2026."
Last month, sources told PTI that the government is likely to begin administering anti-cervical cancer vaccine in girls aged nine to 14 years in six states in June. In the first phase of the vaccination campaign, 2.55 crore girls are targeted to be administered the human papillomavirus (HPV) vaccine in Karnataka, Tamil Nadu, Mizoram, Chhattisgarh, Maharashtra and Uttar Pradesh, an official source told PTI.
The Union Health Ministry has drawn a roadmap to roll out HPV vaccine in the universal immunisation programme and is likely to float a global tender in April for 16.02 crore doses to be procured by 2026, official sources told PTI.
In January, when first made-in-India Human Papillomavirus (HPV) "CERVAVAC" vaccine was launched, Serum Institute of India (SII) CEO Adar Poonawalla had said that the availability of the cervical cancer vaccine will be little in number in 2023, the availability will be boosted next year to take care of the nation’s needs.
(With inputs from agencies)
