Why women health check-up and cancer screening is important?

'Men are from Mars and Women are from Venus'- This metaphore holds good not only in terms of psychology but also in physical health issues. Women's lives have undergone many changes over the past few decades. Earlier, the health of women was considered as a mere reproductive health. However, this notion has led to arguments across many groups to project the word 'women health' in a broader view and refer it to be the overall health of women.

An Indian woman's life expectancy has now come close to 70 years. While cardiovascular deaths are the leading cause of death in women, we are now seeing an alarming increase in women's cancer deaths. Of all the cancers that affect women, the most common cancers are breast and cervical cancers. Breast cancer is now the most common cancer among Indian women, particularly among urban populations.

Whereas, in rural women cervical cancer remains the most prevalent cancer. According to data from Globocan 2018, there were 1,62,468 new cases of breast cancer recorded each year and around 8,7090 patients die each year from breast cancer. If we see our patients' recovery, one in every two women who are diagnosed with breast cancer is dying of it. While in the United States only one in every six women diagnosed with breast cancer is susceptible to death.

This shows that mortality rate in Indian patients is huge compared to the Western countries. Our patients are diagnosed at a very late stage due to lack of awareness and inadequate screening facilities. According to the latest guidelines, women over the age of 50 should have a mammogram done every two years and women in the age of 40 should have an discussion with their doctors about the personalized diagnosis and treatment plan. These recommendations are based on the latest scientific data on potential risks caused by mammographic screening, over diagnosis, false-positive results and benign biopsy. Thus mammographic screening between 50 and 70 years in every two years can outweigh the risks caused by the disease.

Cervical cancer is also a major health issue in India with an incidence of 96922 new cases and 60078 annual deaths. Cervical cancer is caused by the infection with the HPV virus, which develops into cancer on persistence in the body. However, it has a long latency period of 15-20 years which means we have enough time to detect these precancerous lesions on the cervix. We have two main screening modalities for cervical cancer as of now such as pap smear and HPV DNA tests.

Screening should be done in ideal circumstances with a good resource environment at 25 years of age and should be performed up to 65 years. When primary HPV testing or co-testing with pap smear is used for screening, it must be performed every 5 years, but it must be done every 3 years if only pap smear is performed. Pap smear testing should be performed every 5 years starting from the age 30 or atleast 3 times in a lifetime.

With a healthy woman, a healthy family begins. So let's pledge that women will be screened every year with a complete health package and regular cervical and breast cancer screening accordingly.

(The writer is a Radiation Oncologist at American Oncology Institute, Hyderabad)