Overview

Few STIs such as Chlamydia, Syphilis, Trichomoniasis and Gonorrhea can be cured, whereas viral infections such as Herpes Simplex virus (HSV), Human Papillomavirus (HPV), Hepatitis B and Human immunodeficiency virus (HIV) are incurable. Diseases or symptoms due to these viruses can be controlled by treatment . Among these, the Human papillomavirus (HPV) is the major causative agent of cervical cancer (CaCx). Various benign and malignant lesions including anogenital cancer and genital condyloma are associated with HPV. However, cervix is the main target of HPV infection, in many it resolves itself, while in few others it persist and may lead to cervical cancer. In India, 60,078 women with cervical cancer die every year with the incidence of 14.9 per 100,000. The cervix is the end part of the uterus, divided into ectocervix and endocervix. Cervix connects uterus to vagina. Ectocervix is the outer part of the cervix (Portiovaginalis) forming external OS and endocervix is the inner part of the cervix forming a pathway connecting uterus i.e., channels between external and internal OS. Size of the cervix varies with age, hormonal state, and parity. Precancerous lesions in the cervix lead to cervical cancer. According to WHO classification, mild dysplasia can progress to become moderate dysplasia, severe dysplasia, and then progress to cervical cancer. Mild dysplasia may revert on its own without treatment and usually does not progress to moderate or severe dysplasia, except in few cases. Classification of cervical abnormalities is carried out by two systems: First, are classified as CIN1 (Cervical intraepithelial neoplasia): mild to moderate dysplasia; CIN2: intermediate dysplasia; and CIN3: severe dysplasia and carcinoma in situ. According to Bethesda system Low grade squamous intraepithelial lesion (LSIL) is CIN1, and CIN2 and CIN3 are considered as High grade squamous intraepithelial lesion (HSIL). As per the International Federation of Gynecology and Obstetrics (FIGO) invasive cancer is further classified into various stages. Although cancer of the cervix can develop in women of all ages, the peak age is usually between 35-55 years.

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