A Comprehensive Review of Cervical Cancer

Cervical cancer is a type of cancer that occurs in the cervix, which is the lower part of the uterus in the female reproductive system. It is usually caused by the human papillomavirus (HPV), which is a sexually transmitted infection.

Here are some key facts about cervical cancer:

Risk Factors:

- HPV infection (most common cause)
- Weakened immune system
- Smoking
- Family history
- Poor diet
- Lack of regular Pap tests

Symptoms:

- Abnormal vaginal bleeding (e.g., after sex, between periods, or after menopause)
- Pelvic pain
- Pain during sex
- Abnormal vaginal discharge
- Bleeding after menopause

Prevention:

- HPV vaccination (recommended for girls and boys aged 11-12)
- Regular Pap tests (every 3 years for women aged 21-65)
- HPV DNA testing (for women aged 30 and older)
- Practicing safe sex
- Quitting smoking
Treatment:

- Surgery (e.g., hysterectomy)
- Radiation therapy
- Chemotherapy
- Targeted therapy
- Immunotherapy

Early Detection:

- Regular Pap tests can detect abnormal cell changes before they become cancerous
- HPV DNA testing can detect high-risk HPV strains
Cervical cancer awareness is crucial for prevention, early detection, and treatment. Here's a brief overview:

Key Messages:

1. Get Vaccinated: HPV vaccine can prevent cervical cancer (recommended for girls and boys aged 11-12).
2. Get Screened: Regular Pap tests (every 3 years for women aged 21-65) and HPV DNA testing (for women aged 30 and older) can detect abnormal cell changes.
3. Know the Risks: HPV infection, smoking, and weakened immune system increase cervical cancer risk.
4. Be Aware of Symptoms: Abnormal vaginal bleeding, pelvic pain, and pain during sex can be signs of cervical cancer.
5. Take Action: Practice safe sex, quit smoking, and maintain a healthy lifestyle.

Awareness Month: January is Cervical Cancer Awareness Month, but awareness and education should be ongoing.
Goals:

1. Increase vaccination rates
2. Improve screening rates
3. Reduce stigma around cervical cancer and HPV
4. Educate about risk factors and symptoms
5. Support cervical cancer research and survivors
The cervical cancer vaccine is commonly known by the following names:

1. Gardasil (Merck Sharp & Dohme): Protects against HPV types 6, 11, 16, and 18.
2. Gardasil 9 (Merck Sharp & Dohme): Protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58.
3. Cervarix (GlaxoSmithKline): Protects against HPV types 16 and 18.

These vaccines are designed to prevent cervical cancer, as well as other HPV-related cancers and genital warts.
What is HIV?

- A virus that attacks the body's immune system
- Weakens the immune system, making it harder to fight off infections and diseases

How is HIV transmitted?

- Through bodily fluids (blood, semen, vaginal and rectal fluids, breast milk)
- Sex (vaginal, anal, oral)
- Sharing needles or syringes
- Mother-to-child during pregnancy, childbirth, or breastfeeding
- Blood transfusions (rare in countries with screening)
Stages:

1. Unveiling The Silent Threat: A Comprehensive Review of Cervical Cancer Shri Vidyarthi Sudhar Sangh’s NAGPUR COLLEGE OF PHARMACY Wanadongri, Hingna Road, Nagpur-441110 Affiliated to Dr. Babasaheb Ambedkar Technological University, Lonere & Maharashtra State Board of Technical Education , Mumbai DTE CODE- 4656 MSBTE CODE-1922 Presented By: Sakshi Rajendra Ghasle (B Pharm Final Year)

2. Abstract Aim and Objective Literature Review Introduction History of Cervical Cancer Pathology of Cervical Cancer Epidemiology Risk Factors & Symptoms Prevention and Treatment Discussion Conclusion References PRESENTATION OUTLINE :

3. Cervical cancer is one most common gynecological cancer occurring in women. It is also one of the commonest cancer of woman that can be detect and treated completely at precancerous stages. STD is main cause of cervical cancer and also due to the Human Papillomavirus (HPV), mainly HPV-16 and HPV-18. It continues to be major public health troubles for female in India. The incidence of cervical cancer is 55-59 years and a considerable proportion of women report in the late stage of disease. Prophylactic vaccines against HPV-16 and 18 therapeutic vaccines in opposition to cervical cancer. Other epidermalogical risk factor are premature at sexual activity, Teen age pregnancy , Family past, Oral contraceptive. It includes history of cervical cancer, histopathological variety, risk factor, avoidance , treatment and Drug approved to prevent cervical cancer .The most common type of cervical cancer is called Squamous cell carcinoma. Vaccine is helpful only in people who have no previous infection with HPV. ABSTRACT

4. Aim : To Study about the Cervical cancer and reduce the incidence and mortality of cervical cancer through effective prevention, early detection, and appropriate treatment .. AIM & OBJECTIVES Objective 1) Increase Awareness and Education by Promote the importance of regular screening and HPV vaccination. 2 ) Promote HPV Vaccination: Increase the uptake of HPV vaccines among the target population, particularly pre-adolescents and adolescents. Provide public health campaigns to raise awareness about the safety and efficacy of HPV vaccination. 3) Support Research and Data Collection: Encourage and fund research focused on cervical cancer prevention, treatment, and outcomes. Collect and analyze data to monitor the effectiveness of cervical cancer control programs and identify areas for improvement.

5. LITRATURE REVIEW Rakhi Kunkule, Ruchita Pakale, Swati Jadhav Current Trends in Pharmacy and Pharmaceutical Chemistry http://e-currentscience.com/journal/e/CTPPC 2(2), 2020, 39-44 Cervical cancer is one most common gynecological cancer occurring in women. It is also one of the commonest cancer of woman that can be detect and treated completely at precancerous stages. STD is main cause of cervical cancer and also due to the Human Papilloma virus (HPV), mainly HPV-16 and HPV-18. It continues to be major public health troubles for female in India. The incidence of cervical cancer is 55-59 years and a considerable proportion of women report in the late stage of disease. 2) Carolina Gobjila , Doru Anastasiu , Izabella Petre , Zoran Laurentiu Popa , Anca Bordianu , Ion Petre * , Marina Adriana Mercioni , Simona Ioana Sipos 2023 According to cancer death rates for women worldwide, this form of cancer ranks fourth after breast, bronchopulmonary, and colorectal cancer, affecting around 570,000 women annually. About 270,000 women each year pass away from this illness, 85% of them are from underdeveloped nations where cervical cancer claims more lives than any other kind of cancer. In Romania, cervical cancer ranks fourth in terms of death, behind breast, bronchopulmonary, and colorectal cancers, and second in terms of incidence, behind breast cancer.  

6. INTRODUCTION 1) Cervical cancer is a significant public health concern worldwide, posing a considerable burden on women's health and healthcare systems globally. It is the fourth most common cancer in women, with approximately 570,000 new cases and 311,000 deaths reported annually, according to the World Health Organization (WHO). 2) The development of cervical cancer is closely linked to infection with high-risk types of Human papillomavirus (HPV), a sexually transmitted virus. Persistent infection with oncogenic HPV types, particularly HPV 16 and 18 , is a primary risk factor for the development of cervical intraepithelial neoplasia (CIN) and ultimately cervical cancer. 3)Screening for cervical cancer aims to detect precancerous lesions or early-stage cancerous changes in the cervix before symptoms develop advancements in screening technology, including liquid-based cytology and HPV testing , have further improved the sensitivity and accuracy of cervical cancer screening. 4) Moreover, the advent of HPV vaccines , which target the most oncogenic HPV types, has provided an additional tool for primary prevention, offering protection against HPV infection and reducing the incidence of cervical precancerous lesions and cancer.

7. The history of cervical cancer dates back to ancient times, with significant developments occurring over the centuries. cervical cancer date back to ancient civilizations, where descriptions of cervical growths and tumors can be found in medical texts from ancient Egypt, Greece, and Rome. In 1842, German physician Johann Lukas Schönlein provided one of the earliest clinical descriptions of cervical cancer. In 1928, George Papanicolaou introduced the Pap smear, a simple yet revolutionary screening test that allowed for the detection of precancerous and cancerous changes in cervical cells Invasive surgical approaches and targeted therapies in the 21st century, the landscape of cervical cancer management has undergone significant transformations aimed at improving outcomes and reducing morbidity. Since the introduction of HPV vaccination in the early 21st century, significant progress has been made in cervical cancer prevention, with vaccination programs demonstrating efficacy in reducing HPV infections and related cervical lesions. HISTORY OF CERVICAL CANCER

8. The pathology of cervical cancer involves understanding the cellular and molecular changes that lead to the development and progression of disease Cervical cancer arises from the uncontrolled growth of abnormal cells in the cervix, the lower part of the uterus that connects to the vagina. Precancerous Lesions 2) Squamous Cell Carcinoma 3) Adenocarcinoma Pathology Of Cervical Cancer Cervical Intraepithelial neoplasia Represent early stages of cervical Carcinogenesis . Common type of Cervical cancer Approx. 70-80% cases This is arises from Glandular cells lining of endocervical canal Approx. 20-25% cancer cases

9. EPIDEMEOLOGY Cervical cancer is the fourth most common cancer among women globally. In 2020 , there were an estimated 604,000 new cases and 342,000 deaths. High-incidence regions include Sub- Saharan Africa, Latin America, South Asia, and parts of Eastern Europe. In contrast, high-income countries with well-established screening programs, like those in North America and Western Europe, have lower incidence and mortality rates. The epidemiology of cervical cancer is fundamental to its prevention (Green and Kreuter,2004) Yet, acceptability has not been adequately characterized for the groups that may benefit most from the HPV vaccine.

10. RISK FACTORS AND SYMPTOMS Risk Factors associated with Cervical Cancer Symptoms associated with cervical cancer Human Papilloma Virus : HPV 16 & HPV 18 Sexual Behavior : Early Sexual Activity and Multiple Sexual Partners Immunosuppression : HIV infection Smoking Long term use of Oral Contraceptives Multiple Full term Pregnancies Young Age at First Full Term Pregnancy Socioeconomic Status Family History Exposure to Diethylstilbestrol Early – Stage Symptoms Asymptomatic Advanced- Stage symptoms Abnormal vaginal Bleeding Unusual Vaginal Discharge Changes in Bowel or Bladder Habbits Legs Pain or Swelling Lower Back Pain Rare symptoms in Advance Stages Unexplained weight loss Fatigue Loss of Appetite Swelling of the Lower Extremities

11. PREVENTION AND TREATMENT PREVENTIONS TREATMENT HPV Vaccination Regular Screening: Pap Smear test & HPV testing Safe Sexual Practices : Mutual Monogamy Lifestyle Choices : Healthy diet Education and Awareness : Public health Campaigns Regular Health Check-Ups Early-Stage Cervical Cancer Surgery : Conization Hysterectomy Rachelectomy Lymph Node dissection Locally Advanced Cervical Cancer Radiation Therapy : EBRT & Brachytherapy Chemotherapy Advanced and Metastatic Cervical Cancer Chemotherapy : Systemic Targeted Therapy Immunotherapy

12. CHEMOTHERAPY DRUGS USED TO TREAT CERVICAL CANCER CISPLATIN : ( Platinol ) CARBOPLATIN ( Paraplatin ) TOPOTECAN

13. CERVICAL CANCER VACCINES 1) CERVARIX : Cervarix Vaccine is a vaccine used to prevent cervical cancer in women T o prevent the disease caused by HPV types 16 and 18 . A dministered by injection to females aged between 9 and 45 years 2) GARDASIL : Gardasil Vaccine is a vaccine used to prevent cervical, vulvar, and vaginal cancers associate with human papillomavirus (HPV) in women . The vaccine works by increasing your body’s immunity against the human papillomavirus.  

14. DISCUSSION The cervix is located in the lower part of the uterine cavity and is lined with two types of cells: glandular and squamous. The junction area of the two cell types is called the transformation area. This area is very important because most cervical cancers occur here. From the total case of neoplasms, histologically two major histological types of an epithelial tumor of the cervix are identified: squamous cell carcinoma (95%) and adenocarcinoma (5%). Pre-treatment surgical evaluation should also be considered. Extending screening and vaccination programs can lead to reductions in the incidence and mortality of cervical cancer.

15. CONCLUSION Cervical cancer is a preventable and treatable disease if detected early. Comprehensive prevention strategies, including HPV vaccination , regular screening, and addressing healthcare disparities, are crucial. Continued efforts in research, public health education , and international cooperation are necessary to reduce the global burden of cervical cancer and improve outcomes for women worldwide. Histopathology and immunizationization important for reducing cervical cancer. HPV vaccine is highly efficacious and is probable to significantly reduce the occurrence of abnormal pap smears, cervical cancer and genital warts. Successful implementation of vaccination programs will have a huge support from health care provides great have been made decreasing the cancer rate

16. REFERENCES Rakhi Kunkule, Ruchita Pakale, Swati Jadhav Current Trends in Pharmacy and Pharmaceutical Chemistry http://e currentscience.com/journal/e/CTPPC 2(2), 2020, 39-44 Stelze, Dominik et al. Estimates of the global burden of cervical cancer associated with HIV. The Lancet. 2020. https://doi.org/10.1016/S2214- 109X(20)30459-9 Carolina Gobjila , Doru Anastasiu , Izabella Petre , Zoran Laurentiu Popa , Anca Bordianu , Ion Petre * , Marina Adriana Mercioni , Simona Ioana Sipos 2023 H Shun J Ferlay, RL Siegel, M Laversanne, I Soerjomataram, A Jemal, F Bray CA: a cancer journal for clinicians, 2021•Wiley Online Library Kjaer SK, Frederiksen K, Munk C, et al. Long-term absolute risk of cervical intraepithelial neoplasia grade 3 or worse following human papillomavirus infection: role of persistence. J Natl Cancer Inst. 2010;102:1478–1488 Kulasingam SL, Havrilesky L, Ghebre R, Myers ER. Screening for Cervical Cancer: A Decision Analysis for the US Preventive Services Task Force. AHRQ Publication No 11-05157-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2011

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