The Cervical Cancer - Essay Example

The Cervical Cancer Introduction The lower part cylindrical part of the uterus is known as cervix. This portion of the uterus is not as moveable as the body is. It consists of the cervical canal which is also known as the space in the cervix. The lower part of the cervix is in relation with the upper part of the vagina. It allows the passage of sperm and menstrual blood to pass through the uterus to the vagina. Cervix is an important site for the development of cancers and genital tract infections. The cancer of cervix has been known as a leading cause for the death of millions of women around the world. However nowadays the therapy provided for the cure of the disease is suitable enough to prevent the disease from spreading. The cancer arises from a virus known as Human Papillomavirus (HPV). This virus is usually transmitted through sexual activity. This virus can further lead to the development of cervical intraepithelial neoplasia. This neoplasia consists of dysplasias such as CIN grade I and CIN III. These dysplasias then lead to cell carcinomas such as squamous cell carcinoma or adenocarcinoma. Squamous cell carcinoma or adenocarcinoma has the tendency to cause invasive cell carcinoma which can then have lethal effects on the individual. The cancer usually works in such a course that the cell composition of the cervix is changed. The cells thicken in the first stage giving rise to lesions in the area. Then the cells develop carcinomas in the situ and lastly metastasis begins in the organ giving rise to the cancer. The cancer can be diagnosed by cytologic screening or management of Papanicolaou smear abnormalities. The cancer can then be removed by surgical intervention or by the use of vaccines. These vaccines can either be used to prevent the spread of the disease or the complete removal of the cancer from cervix. It is also seen that the cervical cancer usually occurs in women all around the world and it has been a source of concern for the world since many decades (Robbins et al 2005 & Robbins et al 2003). This essay would further provide a detailed epidemiology on cervical cancer regarding the people, age group and territories. Epidemiology Cervical cancer is mostly related to the sexual activities of the individual as the virus usually tends to enter the region through these activities. It is seen through different studies that cervical cancer is usually prevalent in women who are young of age. These women usually tend to be in their mid twenties. To further confirm this a survey was conducted in Ontario which showed that the prevalence rate of women of women between twenty to twenty four was 24%.Usually this high rate in women is related to their irregularity in the check ups of smear and Pap tests. Women affected by cervical cancer can be estimated to be around 500,000 among which 270,000 of them do not survive. It has been seen that the women are the most to be affected by cervical cancer. The women to be most affected are seen to be belonging to the class of white women whereas Hispanic, African-american, asian and native Alaskans follow the list. The following graph shows a incidence rate of cervical cancer in different groups of people Similarly the women who tend to lose their lives because of the cancer are the ones who are most affected by it i.e. the white women ((Canadian Cancer Statistics 1991 & U.S Cancer Statistics Working Group) It has been noted that cervical cancer is one of the most occurring cancers in the world. Cervical cancer is said to be the third most common cancer affecting women all over the world (Parkin et al 1999). Most of the cases of cervical cancer have been reported from the developing countries whereas quite a many have also been reported from the developed world. But this rate has decreased tremendously after the arrival of cytologic screening and other tests. It is also seen that the highest rates of cervical cancer can be found in Central America, Melanesia, southern and eastern Africa, the Caribbean and South America whereas the low rates of cervical cancer can be found in North America, Southern and Western Europe, China and Japan (Parkin et al 1999). In the United Kingdom it has been seen that the annual rate for cervical cancer in women is 8.4 per 100,000 females (Silva & Doll 2001, Cancer Research UK 2006). Similarly in Czech republic it is seen that the incidence rate is 20.0 per 100,000 females. It is seen that the women most affected in Czech Republic are the ones below the age of 45. Similarly it is also seen that the incidence rate of cervical cancer in United States is 8.9 per 100,000 people. And the mortality rate is 10 per 100,000 people (Bray 2005, Tachezy 2007 & Dusek et al 2007). The trends of cervical cancer in Canada show that it is the 12th most common cancer in the state. It shows that women are the ones mostly who are diagnosed by this type of cancer. Similarly women whose age is from 20-40 the incidence rate of cervical cancer is the third of all the cancers. The incidence rates of cervical cancer in Canada are variable as per the different regions in it. The Atlantic provinces showed the highest rate of cervical cancer from the years 1982-86 and 1992-96. Similarly British Columbia showed low rates of cervical cancer and this is primarily because of the programs it had enacted for the treatment of cervical cancer. The incidence rate of cervical cancer in B.C in 1993 was 7 and in Saskatchetwan it was nearly 8. It was found that the highest incidence rate was in N.W.T and this was possibly because of the low numbers of cytologic labs developed. Manitoba and Ontario also showed higher incident rates. The mortality rates were higher in the British Columbia though. The mortality rate in Canada has decreased over time because of the introduction of screening programs and Paps programs. These programs have helped to develop a diagnosis for the cancer which further help the pathologists to cure the disease easily ((Vizcaino et al 1998, Probert et al 1999, Gorey et al 1997, Canadian Task Force 1994, Statistics Canada 1990, Canada 1998, Laboratory Centre for Disease Control 1998). It has been noted that the worldwide trends for cervical cancer show a rapid decline after the 1990s. This decline has been directly related to the evolution of the new tests which help in the diagnosis of the disease. Similarly in Canada it was seen that the incidence rates of cervical cancer decreased in the late 1970s but this decrease was not rapid. And over the years similarly after 1990 the incidence rate has further decreased because of the introduction of Pap smear. With the decrease in the incidence rate of the cervical cancer the mortality rate in Canada has also decreased significantly showing the great benefits of screening and Pap smear in the region. The following graph shows a reduction in both the mortality and incidence rate of cervical cancer in Canada Moreover it is still seen that squamous cell carcinoma is the most common cause of invasive carcinoma worldwide (Probert et al 1999 & Liu et al 2001). Summary The incidence rate and mortality rate of the cervical cancer clearly show that the cancer is a cause of concern to the world since many years. It is seen that the cancer is amongst one of the common cancers affecting the people in the world. It is also seen that the women are the ones who are mostly affected by this cancer. The epidemiology clearly suggests that the human papillomavirus is the cause of the disease because the women most affected are the ones who are involved in sexual activities i.e. women below the age of 50. The cancer is causing the cells of the cervix to change and thus causing metastasis in cervix. This metastasis can then lead to complications in the uterus and vagina. However after analyzing the epidemiology of cervical cancer it can also be concluded that with the increase in the tools for screening and other tests the incidence of cervical cancer has been decreased worldwide. The tools help to detect the cervical cancer in its preliminary stages where it can be cured with the help of proper intervention. And because of the decreasing incidence rates the rates of mortality have also decreased. Although the incidence and mortality rate of cervical cancer have been decreased significantly all over the world, it still remains a cause of concern to the world. In Canada the incidence and mortality rate of cervical cancer has decreased but the disease has yet not been completely eradicated. Thus there is a room for improvement in the number of tools for the diagnosis of the disease (Robbins et al 2005). References Kumar, V., Cotran, R. S., & Robbins, S. L. (2003). Robbins basic pathology. Philadelphia, PA: Saunders. Kumar, V., Abbas, A. K., Fausto, N., Robbins, S. L., & Cotran, R. S. (2005). Robbins and Cotran pathologic basis of disease. Philadelphia: Elsevier Saunders. Bray F, Carstensen B., Møller M., Kappa M., akelj M.P., Lawrence G., Hakama M., Weiderpass E.: Incidence Trends of Adenocarcinoma of the Cervix in 13 European Countries. Cancer Epidemiol Biomarkers Prev, 2005, 14, 2191 – 2199. Tachezy R., Rob L. Skrínink pro prevenci karcinomu děložního hrdla v České republice. 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