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World Cancer Day: Decline In Cancer Screening Due To COVID-19 Fear

Every year on 4 February, the World Cancer Day is celebrated, which is a global initiative led by the Union for International Cancer Control (UICC) in 2000. The day is meant to educate people about cancer and raise worldwide awareness to save millions of preventable cancer deaths.

On the occasion of World Cancer Day, the doctors of Paras Healthcare and Apollo Cradle Hospital spoked about cancer screening among the pandemic. According to them, most of the gynaecological cancers such as cervical and breast cancer are preventable with awareness about symptoms and timely diagnosis, including routine screening.

However, due to the lockdown restrictions and subsequent fear of COVID1-9 infection, people have avoided visiting hospitals for regular screening. Doctors say that such fear of getting infected on visiting hospitals has caused irregularity in medical screening, resulting in a 47 per cent drop in women screening for early detection of breast cancer in 2020.

According to a Dr (Col.) R. Ranga Rao, Chairman, Paras Cancer Centre, Paras Healthcare, of all cervical cancer patients seen in a month, in only 30-40 % cases cervical cancer is timely detected and only 25% women are aware of the disease and preventive care measures for the same. This can cause an overall rise of 20 per cent in cervical cancer.

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What Is Gynecologic Cancer?

Gynecologic cancer (gynaecological cancer) refers to the development of cancer or tumour cells in the reproductive organs of a woman's body. The most common forms are uterine cancer, cervical cancer and ovarian cancer while vulvar cancer, vaginal cancer and gestational trophoblastic tumour are the relatively rare cancers.

Each gynecologic cancer has its own signs and symptoms, risk factors and preventive strategies. Early detection of these cancer types may help in their effective treatment.

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Symptoms Of Gynecologic Cancer

Symptoms of gynecologic cancer are confusing as they are similar to many other gynae conditions. Therefore, it is very important to notice the changes in your body and understand what is normal and what is not. Also, the signs vary from individual to individual.

According to the CDC, the common symptoms of gynecologic cancer include:

  • Abnormal vaginal bleeding/discharge, except in vulvar cancer.
  • Vaginal odour and bleeding after sexual intercourse in cervical cancer.
  • Pelvic pain or pressure similar for ovarian and uterine cancers.
  • Frequent need to urinate and/or constipation similar in ovarian and vaginal cancers.
  • Feeling of fullness too quickly, difficulties in eating and bloating for ovarian cancer.
  • Itching, burning sensation, pain or tenderness of the vulva along with changes in the colour of vulva only in vulvar cancer.
  • New lump in the breast or underarm, thickening or swelling of any part of the breast, irritation or dimpling of breast skin, redness or flaky skin in the nipple area or the breast, nipple discharge other than breast milk, including blood, changes in the size or the shape of the breast and pain in any area of the breast only in breast cancer.
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What Is Cervical Cancer?

Cervical cancer is a type of gynaecological cancer that grow at the lower end of the womb or say, the opening of the cervix. It is regarded as the most common of gynaecological cancers in India and worldwide. [1]

As per the National Cancer Institute, All India Institute of Medical Sciences (NCI-AIIMS) estimates, one woman in India dies of cervical cancer in every 8 minutes.

Is Cervical Cancer Preventable?

Since 2016, India has seen an addition of one lakh new cases of cervical cancer every year. It is very sad as cervical cancer is a completely preventable disease through routine pap smear tests, getting vaccinated against human papillomavirus, which can also cause a rare vaginal cancer, and practising safe sex and personal hygiene.

According to Dr (Col.) R. Ranga Rao, Chairman, Paras Cancer Centre, Paras Healthcare, "Cervical cancer has an extensive pre-cancerous period, usually 10 to 15 years which offers plenty of time to detect and treat it effectively. If the pre-malignant conditions are detected early then, it is possible to treat the disease completely. However, the unfortunate part is that in India, there is a severe lack of awareness and stigma associated with the invasive nature of cervical cancer screening. The lack of screening and vaccination efforts is another reason behind the high number of cervical cancer cases in the country. Even though the HPV (human papillomavirus) vaccine has been included in the Indian Academy of Paediatrics (IAP), it is still not a part of the National Immunisation Programme. The IAP has approved two vaccines that are being used in private clinics. However, the cost and lack of awareness is a big obstacle to its widespread adoption".

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How COVID-19 Has Affected Women Screening For Cancer Detection?

The main problem for women in India will always be the hesitation to seek help for problems pertaining to their intimate parts. The second big problem that has caused an increase in the number of women cancer cases is COVID-19.

"Regular screening is the best way to keep a tab on gynaecological health but the fear of COVID-19 virus has pushed them away from this tool to prevent cancers - at Miracles, we have seen a drop in cancer screening which can increase the number of affected women," says Dr Veenu Aggarwal, Consultant, Obstetrician and Gynaecologist, Miracles Mediclinic & Apollo Cradle Hospital, Gurugram.

According to Dr Aditi Aggarwal, Senior Consultant, Radiation Oncology, Paras Hospitals, lack of skilled clinicians to conduct the examination and collect the specimen and the embarrassment, and stigma associated with the examination are also the main cause.

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To Conclude

The previous year, COVID-19 has impacted the lives of people from around the world. There were drastic changes in outpatient care such as a reduction in routine checkup or follow-ups. As we know that routine checkups are essential for the early detection and prevention of chronic diseases such as cancer, the fear of the infection has obstructed the process and caused an increase in the number of cancer cases.

This year, however, with the arrival of two effective COVID-19 vaccines, one can hope for things to get back to normal, including routine healthcare checkups for the prevention of diseases such as cancer.