The Latest Advances in Cervical Cancer Screening and Prevention
The Latest Advances in Cervical Cancer Screening and Prevention Hello! I’m Dr. Santoshi Nandigam, consultant gynecologist at The Birthwave Clinic, Chennai. In this comprehensive blog, we’ll explore what cervical cancer is, updates in screening, breakthroughs in prevention, and how we implement modern strategies at our clinic to protect women’s health. 1. Knowledge of Cervical Cancer The cervix, the lower portion of the uterus that connects to the vagina, is where cervical cancer starts. Its main reason? a chronic infection with high-risk HPV types, particularly HPV 16 and 18, which cause more than 99% of cervical cancers. Typical signs and symptoms: Unusual vaginal bleeding (after menopause, during periods, or after sexual activity) Unusual vaginal discharge that smells bad, is pink, or is watery Chronic pain in the pelvis Uncomfortable during sexual activity Heavy or protracted menstrual flow Since precancerous changes can frequently be found and treated before they progress, early detection through screening is the cornerstone of cervical cancer prevention. 2.The Importance of Cervical Cancer Prevention About 660,000 new cases and 350,000 deaths from cervical cancer occurred in 2022, making it the fourth most common cancer in women worldwide. The majority of these deaths occurred in low- and middle-income nations with limited access to screening and vaccination. The WHO has set goals to eradicate cervical cancer worldwide: By the age of 15, 90% of girls had received an HPV vaccination. By the ages of 35 and 45, 70% of women had undergone high-performance test screening. 90% of precancerous lesions receive the right care. Reducing this burden requires preventative measures, such as HPV vaccination, thorough screening, and prompt treatment. 3.Developments in Screening for Cervical Cancer Initial HPV Examination The World Health Organization now advises HPV molecular testing as the main screening technique every five to ten years, beginning at age 30 in the majority of populations. Risk stratification by HPV type is now possible thanks to HPV mRNA tests and extended genotyping assays like BD Onclarity, which increase accuracy and cut down on needless follow-up. In accordance with the American Cancer Society and ASCCP, the USPSTF encourages women aged 30 to 65 to have HPV tests performed by clinicians or by themselves every five years, and women aged 21 to 29 to have cytology-only screening every three years. Dual-Stain Cytology (CINtec PLUS) A significant advancement was the WHO’s approval of dual-stain cytology, which looks for p16 and Ki-67 biomarkers, as a method of triage for women with HPV. The ASCCP has incorporated it into its updated 2025 guidelines to identify women who are most at risk in order to reduce unnecessary colposcopies. HPV Self-Sampling Examinations According to recent research, self-collected HPV swabs are just as accurate as samples obtained from clinicians, and they also increase screening rates for women who are not being screened enough. This is being used by programs in Sweden, Australia, and now some areas of the United States to boost involvement. Many users preferred an FDA-approved at-home uterine swab device, which resembles a tampon and has a 98% accuracy rate in first-attempt sample collection, over in-office exams. New Tools for AI In cytology classification, state-of-the-art AI systems such as Smart‑CCS (which employs large-scale pretraining and real-time adaptation) and transformer-based models (like EVA-02 fine-tuning) currently achieve AUCs of 0.95–0.97, indicating high accuracy in a variety of settings. With telemedicine support, AI-assisted smartphone-based VIA screening is showing promise in low-resource areas, assisting nurses in conducting high-quality cytology camps. 4.HPV Vaccination: Key Developments in Prevention With a 90% reduction in cervical precancer risk and more than ten years of long-term protection, the HPV vaccine has been revolutionary ([turn0search44]turn0search38). Based on studies demonstrating over 97% protection against HPV-16/18, WHO now recommends single-dose schedules for girls and young women aged 9–20, increasing access to vaccination globally . Even though HPV vaccines like Gardasil and Cervavax are not yet included in India’s universal immunization schedule, efforts are being made to incorporate them into public health campaigns. The American Cancer Society has called attention to lagging cervical cancer prevention in some populations because, despite advancements, many women are still not screened . 5.Treatment of Precancerous Lesions in Modern Times In particular, women living with HIV or in settings with limited resources should prioritize screening, triage, and treatment, according to WHO’s updated guidelines. These days, available treatments include: Either thermal ablation or cryotherapy Loop Electrosurgical Excision Procedure, or LEEP Cold knife conization is particularly useful when high-grade lesions are detected by dual-stain testing or extended genotyping. The development of invasive cervical cancer is significantly slowed down by these early interventions. 6.Patient Journey at The Birthwave Clinic Step 1: Risk Assessment Review medical and sexual history Offer HPV testing and/or Pap smear-incorporating extended genotyping or dual-stain cytology as needed Step 2: Examples of Choices Clinician‐collected Pap/HPV Self-sampling kits for women preferring home-based testing-especially helpful for those uncomfortable with pelvic exams Step 3: Advanced Triage HPV-positive women may receive dual-stain cytology Closer monitoring and shorter screening intervals are provided to high-risk individuals (such as women with HIV or those with a history of abnormal results). Step 4: Therapy Treatment with cryotherapy, LEEP, or other conservative excision methods is scheduled if precancerous changes are found. Invasive disease is the reason for referrals to oncological services. Step 5: Continued screening in accordance with WHO/ASCCP guidelines HPV vaccination reinforcement if it hasn’t been given before Step 6: Prevention Counseling Talk about HPV vaccination, which is best suited for people aged 9 to 45. PAP follow-ups, smoking cessation, and safe sexual behavior as components of all-encompassing cervical cancer prevention 7.The Significance of These Innovations More sensitivity and longer safe intervals are provided by HPV primary screening, which lowers frequency without compromising safety. Dual-stain cytology maintains accuracy and safety while drastically lowering needless referrals. Self-sampling improves uptake among past-due individuals and fills accessibility gaps. Automated accuracy scalable to various clinical settings and LMIC environments is what AI-enhanced tools promise. HPV vaccination in a single dose provides a highly effective and more accessible public health approach. 8.Reasons for Selecting The Birthwave Clinic to
Cultural Taboos and Reproductive Health: Breaking the Silence for Better Well-being
The Global Impact of Reproductive Health Taboos 1. Lack of Education and Awareness In many countries, reproductive health is not included adequately in school curriculums due to social discomfort. As a result: Young people enter puberty confused and afraid. Misinformation spreads through peer networks or unreliable online sources. Teenagers may not understand the risks of unprotected sex or the importance of consent. According to UNESCO, over 50% of girls in India are unaware of menstruation before their first period. 2. Menstruation Myths and Stigma In various cultures, menstruation is considered unclean or impure. This leads to: Girls missing school during their periods. Women being excluded from religious practices or kitchens. Hesitation in seeking medical care for menstrual disorders like PCOS or endometriosis. Menstrual hygiene is also compromised when women lack access to clean sanitary products or feel embarrassed to buy them. 3. Sexual Health Silence Sexual health is often linked to morality, especially for women. This stigma: Prevents people from asking questions about their own bodies. Makes condom use a taboo topic. Increases vulnerability to STIs due to unprotected sex. People fear judgment, shame, or dishonor when seeking help for sexual health concerns, which leads to untreated infections and emotional distress. Cultural Taboos and Women’s Health While men also face reproductive health challenges, women bear the heavier burden of cultural taboos. Here’s how: 1. Pregnancy and Fertility Pressures In many cultures, a woman’s worth is tied to her ability to bear children. Infertility is often blamed on women, even though it can affect any gender. Infertile women face social isolation, domestic abuse, or even divorce. Many are pushed toward unregulated fertility treatments or unethical practices. Conversations about IVF, surrogacy, or adoption are considered taboo. 2. Contraception and Reproductive Autonomy Using contraceptives is seen as a sign of promiscuity in many conservative societies. Myths like “the pill causes infertility” or “condoms promote immorality” prevent their widespread use. This limits family planning options and increases: Unplanned pregnancies Unsafe abortions Maternal mortality rates 3. Abortion Stigma Even in countries where abortion is legal, stigma surrounds it. Many women: Choose unsafe abortions due to fear of being judged. Face mental trauma and social exclusion. Avoid post-abortion care, risking serious complications. The Role of Religion and Tradition Religious beliefs often play a major role in defining what is considered acceptable in reproductive health. While faith can provide comfort and community, it can also: Discourage contraception or abortion. Promote gender roles that prioritize motherhood over personal choice. Silence victims of sexual abuse by emphasizing honor over justice. It’s important to respect cultural diversity while advocating for informed healthcare choices. Education, not judgment, is the key. Effects on Mental Health Cultural taboos don’t just harm physical health—they also have a major impact on mental well-being. When individuals cannot speak openly about reproductive issues, they may suffer from: Shame and guilt Anxiety and depression Isolation and low self-esteem For example, women dealing with infertility often feel like failures, while teenagers struggling with puberty changes may feel confused and alone. Breaking the Silence: What Can Be Done? 1. Comprehensive Sex Education Implementing age-appropriate, science-based sex education in schools helps children and adolescents: Understand their bodies Learn about consent, boundaries, and healthy relationships Reduce the risk of teenage pregnancies and STIs Sex education should be inclusive of all genders and sexual orientations and should address the emotional aspects of relationships. 2. Community Engagement and Dialogue Start conversations in local communities to normalize discussions around reproductive health. This can be done through: Workshops and seminars Mother-daughter or father-son sessions Local influencers and faith leaders addressing taboos When leaders speak out, communities are more likely to listen. 3. Media and Social Campaigns Social media, TV, and radio can play a powerful role in changing mindsets. Campaigns that use storytelling, humor, or relatable content have been successful in: Busting myths Promoting menstrual hygiene Encouraging STI testing and safe sex practices Hashtags like #PeriodPositive, #MyBodyMyChoice, and #EndTheStigma have gained traction globally. 4. Accessible Healthcare Services Governments and healthcare institutions must ensure that: Reproductive health services are available and affordable Clinics are non-judgmental and gender-sensitive Health professionals receive training on cultural competence Mobile clinics, telemedicine, and youth-friendly health centers can make a significant difference in underserved areas. Case Study: Breaking Menstrual Taboos in India Organizations like Menstrupedia, Goonj, and The Pad Project are revolutionizing menstrual health education in India. Through comic books, low-cost pads, and awareness drives, they are: Educating young girls in rural and urban areas Engaging boys and men in conversations Challenging centuries-old stigmas Result: Better school attendance, increased confidence, and healthier hygiene practices. Why Reproductive Health Is a Human Right According to the World Health Organization (WHO), reproductive health is a state of physical, mental, and social well-being—not just the absence of disease. This includes: The right to make informed decisions about one’s body Access to education and healthcare The freedom to choose if, when, and how to have children Cultural taboos violate these rights by limiting knowledge, choice, and dignity. Conclusion Breaking cultural taboos around reproductive health is not about disrespecting tradition—it’s about empowering individuals with the right to make informed choices about their bodies and lives. Through education, community support, and healthcare access, we can move toward a world where reproductive health is seen not as shameful, but as essential. It’s time to replace silence with conversation, myths with facts, and fear with freedom.
Why to Maintain a Food Diary:
Why to Maintain a Food Diary: A Key to Mindful Eating and Fertility Why to Maintain a Food Diary Healthy Foods : When I ask my patients trying to conceive about their eating habits, they often draw a blank. Questions like “What did you have for breakfast yesterday?” or “When was the last time you had junk food?” are met with confusion. Many wonder why, instead of immediately prescribing fertility treatments, I’m asking about their diet. The truth is, your body’s ability to conceive is intricately linked to what you eat. While age is an important factor in fertility, it’s not the only one. Your body needs to feel safe and well-nourished to support conception, ovulation, fertilization, and embryo growth. This is where maintaining a food diary becomes crucial in your journey to conceive. Junk Foods : As someone who believes that FOOD is MAGIC and can be the solution to many of our problems, I can’t stress enough how important it is to be mindful of what we eat, especially when trying to conceive. We must brutally accept that we often don’t eat right. Correcting this is crucial while you’re on your Trying To Conceive journey. Here’s a suggestion from a fellow ‘messed up eater’: maintain a food diary. Let’s get into more details What is a Food Diary? It’s nothing fancy. It’s just a documentation of what you have eaten over the day. Breakfast, lunch, snack, dinner, beverages. Even the most conscious eater, may not be getting the recommended daily allowance of macro or micro nutrients appropriate for their weight, height, age and lifestyle. And I say this with a lot of experience. Correcting this, which is probably the root cause of sub-fertility is extremely important. It’s common to feel over whelmed when words like RDA, are thrown around. Don’t be! The next couple of paragraphs are for people who are in their Trying To Conceive journey, having issues with fertility, undergoing fertility treatments. Having a conscious understanding of what goes into your body to help you survive through the day is quintessential. When you maintain a food diary and write down everything that you have eaten or drunk in a day, you get to understand the mind-body equation of hunger and satiety well. There are two hormones in our body which determine our eating habits. Ghrelin and Leptin. Ghrelin is the hunger hormone, the more of it gives us hunger pangs and pushes us to eat. Leptin is the satiety hormone, which does the opposite. Somewhere in between our body also deals with something called as ‘cravings’. And when you are on your weight loss journey or trying to conceive journey – cravings are not your best friend! Giving in to them is silently yet possibly changing the whole hormone balance, energy homeostasis and sugar metabolism. A pop of candy after meals which started as taste test of a new bar hanging at home, may not even seem like a big deal, only for you to realize couple of months later that your body is accustomed to eating sweet after meals. And that’s a silent craving there my love! Let me tell you something super interesting. We eat because we are wired to act on the lines of hunger. Our body demands food. We also eat because our emotions drive us closer to food. And this is not hunger. This is purely an interplay at the ARN – Appetite Regulatory Network of the Hypothalamus. This is happening at a different level of consciousness. Maintaining a food diary can help identify and modify these patterns. Benefits of Maintaining a Food Diary Weight loss and weight loss maintenance. If you’re someone who’s concentrating on reducing your calorie intake . Mindful eating – you don’t need that extra packet of chips which you reach out to when you’re bored. You don’t have to munch in . Identifying trigger foods and food sensitivities. Address stress eating The first step in building better habits is to be aware of the existing habits. The whole world is now talking about GUT MICROBIOME and its role in health and harmony of the body. Its role in practically functioning of every organ in the body from digestion, removing toxins, fertility, longevity etc. Looking back in the past couple of years and our heavy dependence on antibiotics for various physical ailments, our consumption of processed and ultra processed foods would have taken a huge toll on the MICROBIOME and there has been a significant increase in the incidence and prevalence of Irritable Bowel Syndrome, Gluten sensitivities and food allergies. By maintaining a food diary, you can better relate to your body’s signs and symptoms in response to specific foods. There is better relatability. If You’re New to Maintaining a FoodDiary, Here’s a Step-By-Step Guide: If you are a virgin at FOOD DIARY, here’s a step by step guide to starting and maintaining one, without over whelming yourself. Start slow, it is not a competition to win. You don’t have an opposition. So stop fighting with yourself, start it like a fun activity. Document your major meals – breakfast, lunch and dinner. Give details about the quantity, company and ambience. Once you get into the flow of documenting the major meals of the day, level it up by noting down beverages. From your morning coffee to the peer pressure coffee you have in that office break. The more details you include, the better is your awareness. And being aware of your own habits is the first step to mindful clean eating. Do this for about 15 days before you notch it up by including your snacks. Don’t forget the midnight biryani. I live in Chennai and the city is lit with food parks and stalls till 4am! And by lit, I don’t mean lit with lights, it’s also lit with people! If you have come all this while, you probably survived the most difficult part of any task – CONSISTENCY! So why not write down a line
