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Which age group is most vulnerable to cervical cancer?

Dr B Shakuntala Baliga MD (AIIMS), FICOG
Professor and Senior Consultant Gynecologist & Colposcopist
Mazumdar-Shaw Center for Cancer Research & Narayana Hrudayalaya Multispecialty Hospital, Bangalore

Q: I am a 28 years old female. We are organising a cervical cancer awareness programme in our office and for that purpose, we need answers to the following questions about cervical cancer:- 1. Which age group is most vulnerable to cervical cancer? 2. Which conditions will make them susceptible to cervical cancer/HPV infection? 3. How can cervical cancer be prevented? 4. What is the status of the vaccines availability in India? 5. Which of the two vaccines - Gardasil or Cervarex is better? 6. What are the different specifications for taking the vaccines? 7. Can women who've had one or more sexual encounters take the vaccine? 8. Can women who are taking birth control pills take the vaccine?

A:1 Women of what age bracket are most vulnerable. In India,cancer cervix has peak age incidence in the 50s. However, aim of screening is to detect the prcancer stage- which occurs almost 15 years ahead. So if a country has limited resources, we advise screening every woman at least once in her lifetime around age 35-40 years. Data for precancer in adolescents is not avaialble for India as hardly any adolescent in India comes for health check, despite early age of marriage still being prevalent in India.2 What conditions will make them susceptible to cervical cancer/HPV infection. Early age of marriage/ sexual activity (especially before age 16 years)Multiple partnersEarly age of first child birth (especially before age 17 years)Multiple pregnancies (>/= 5 childeren)SmokingUse of combined oral contraceptive pills (slight increase in precancer- probably related to life style)Diet deficient in nutrients and vitaminsPoor genital hygieneUnsafe sexOccurrence of Sexually transmitted infections- especially HPV, herpes, chlamydia,gonorrhea3 What are the measures of prevention.Primary prevention by 1. life style changes- refer to above conditions and 2. vaccinationSecondary prevention by screening wih Pap smear and high-risk HPV DNA test (latter test is useful in women after age 35years) (to detect and treat precancer)4 What is the status of the vaccines' availability in India.Both the vaccines- Gardasil (against HPV 16, 18, 6 and 11)and Cervarex (against 16 and 18) are available in India5 Which of the two vaccines is suggested/or is better.Both are equally good for prevention of cervix cancer6 What are the different specifications for taking the vaccines.Please refer to websites of Gardasil and Cervarex for detailed information7 Can women who've had one or more sexual encounters take the vaccine.Yes, but it works best in those who have not been sexually exposed before taking vaccine8 Can women who are taking birth control pills take the vaccine.Yes.You can contact the representatives of Gardasil (MSD pharnaceuticals)and Cervarex(GSK) through their websites. They will be more than happy to arrange for a doctor to talk to your employess and staff.