Ending Cervical Cancer Is Possible

— And the Tools Already Exist

By Bavina Sookdeo

“Cervical cancer is a disease that no woman in this era should die from” said 42-year-old obstetrician and gynaecologist Dr Rachel Corridon in an interview with ADVO.

Corridon, who is also known as ‘Your Gentle Gynecologist’ and serves both in private practice through Harmony Health TT and as a Specialist Medical Officer in the public health sector in Trinidad explained that cervical cancer is one of the few cancers we truly have the tools to prevent. “Globally, organisations such as the World Health Organization are now focusing not only on screening, but also on widespread HPV vaccination of adolescent girls and boys. The aim is to eliminate cervical cancer as a public health problem and prevent unnecessary deaths.”

Cervical cancer develops from abnormal changes in the cells of the cervix (also known as the neck or mouth of the womb/uterus). These changes usually occur on the outer surface of the cervix or within the cervical canal.

According to the World Health Organization (WHO), cervical cancer could become the first cancer ever eradicated if three global targets are met: 90 per cent of girls vaccinated against HPV, 70 per cent of women screened, and 90 per cent of women diagnosed receiving appropriate treatment. Corridon stressed that achieving these targets is both realistic and urgent — and has the potential to save countless lives.

But why is it often described as one of the most preventable cancers? Posed with this question, Corridon explained that in most cases, cervical cancer develops slowly, beginning with pre-cancerous changes. Persistent infection with Human Papillomavirus (HPV) is typically responsible for these changes. “These key factors lead to the ability to prevent cervical cancer, firstly by the early detection of precancerous cells through cervical screening programmes and secondly by vaccination against HPV” she said.

HPV is the most common sexually transmitted infection worldwide. “Eighty percent of women become exposed to HPV during their lifetime,” Corridon noted. She explained it is a viral infection that, once it enters your cells, dysregulates your cellular system, allowing it to replicate, and the resulting viral copies then infect nearby cells. She reiterated that this is a slow process, and for most people, the immune system clears the virus before it causes disease.

“Persistence of the HPV virus in the body, typically beyond two years, and with high-risk types of HPV, leads to progressive changes in the cells on the cervix, eventually leading to cancer” she added. The process can take three to seven years and Corridon emphasised this is where cervical screening is important – detecting and treating changes before they become cancer.”

But are there specific HPV strains that are more dangerous than others? Corridon responded, “Yes, there are over 200 strains of HPV.” She said approximately 13 are high-risk types linked to 99.7 per cent of cancers of the cervix, vagina, penis, anus, mouth and throat. Of these, the most related to cancer are HPV types 16, 18, 31, and 45. Low-risk HPV types cause about 90 per cent of genital warts.

“Since our bodies are able to eliminate the infection without obvious signs, many individuals do not realise they have been exposed” the doctor noted.  

She emphasised that vaccination is most effective before exposure to HPV. “The optimal age group for HPV vaccination isthe adolescent group, comprising girls and boys aged nine to 14. At this age, they are assumed not to have been sexually active yet and therefore have not been exposed to the HPV virus,” she explained.

However, a major concern of parents is the safety of the vaccine. The doctor related that the HPV vaccine first became available in the USA in 2006 and in the UK in 2008. There have been variations in the vaccine regarding the strains incorporated by different Pharmaceutical Companies. “The most common side effects are injection site soreness and redness” she said adding, “The vaccine is safe. In the UK, the vaccination programme has led to the near eradication of cervical cancer in women born after 1995.”

For parents hesitant about HPV vaccination, Corridon offered reassurance. “The HPV vaccine is for cancer prevention, and not permission for sexual activity,” she said. “Protecting your child now can save their life and the lives of others in the future.”

For individuals who missed early vaccination, she reassured that it is not too late. “The vaccine is approved for people up to age 45,” she said.

And while many may think HPV vaccination is just a women’s issue, that is not the case. Corridon says adolescent boys should be vaccinated as well. “This is important because HPV is the most transmitted STI, so vaccination of males protects the females they will encounter during their sexual life.”

While vaccination prevents HPV infection, screening saves lives by catching disease early. “Cervical screening is advised for women between the ages of 21 and 65,” Corridon said. “With liquid-based cytology, the Pap test can be repeated every three years, and with HPV testing every five years.”

“The famous mantra is ‘Early detection saves lives,’” Corridon said. “Screening aims to detect precancerous changes and direct women to treatment options early. This reduces the risk of cancer and death. For some women, they can preserve their fertility, and for others, their quality of life. Treatment options are also simpler when early changes are detected.”

When cervical cancer is detected early, outcomes are overwhelmingly positive. “Survival rates for early-stage cervical cancer exceed 90 per cent with prompt management,” explained Corridon.

Treatment for cervical cancer is tailored to each patient and managed by a multidisciplinary healthcare team. Depending on the stage, care may involve minor procedures, surgery such as hysterectomy or trachelectomy, radiotherapy, chemotherapy, or a combination of treatments.

Despite access to services, fear still keeps many women away from screening. “To women who are afraid, I say: knowledge is power, and action may determine life or death,” Corridon said. “Screening is quick, private, and far less frightening than the consequences of late detection.”

She also cautioned against complacency: “Feeling well does not mean all is well. Remember that although HPV is the most commonly transmitted STI, you may likely exhibit no symptoms of infection. Screening is an act of self-care and self-love and can save your life.”

In Trinidad and Tobago, cervical cancer remains a significant public health concern. “It is the third leading cancer among women,” Corridon revealed. “Approximately 200 women are diagnosed each year and 127 die annually, out of a population of just over 600,000 women.”

She believes education is key to changing those numbers. “There is room for more intentional education of adolescents’ parents to increase vaccination uptake,” she said. “Education across all age groups reduces fear, misinformation, cultural stigma, and delayed health-seeking behaviour.”

With vaccination, screening, and treatment working together, Corridon believes the elimination of cervical cancer is no longer a distant dream.