Cervical cancer remains a major challenge to women's health, particularly in low-income areas. This cancer is found in the cervix, the part of the uterus that connects the vagina. The primary cause is infection with the Human Papillomavirus (HPV), a sexually transmitted virus.
According to the 2022 Globocan report, cervical cancer is the second most common cancer in Indonesia, with 36,633 new cases, or approximately 9.2% of the total. Globally, the WHO reports that 90% of the 342,000 deaths from cervical cancer occur in low- and middle-income countries.
This high number of cases is generally due to low public awareness of the importance of early detection and HPV vaccination. In fact, cervical cancer is a type of cancer that can be effectively prevented through routine screening and HPV immunization from an early age.
What is the HPV vaccine?
The HPV vaccine is an immunization that aims to protect the body from Human Papillomavirus (HPV) infection, especially high-risk types that can trigger cervical cancer and other cancers such as those of the anus, throat, and penis.
This vaccine is most effective in children aged 9-14, before they become sexually active. For this age group, two doses are sufficient. Recipients over 15 years of age generally require three doses.
The HPV vaccine doesn't protect against all types of HPV, but it is highly effective against HPV types 16 and 18, the main causes of cervical cancer. Therefore, even after being vaccinated, women are still advised to undergo regular cervical cancer screening, such as Pap smears.
What is a Pap Smear?
A Pap smear is a screening test that aims to identify cervical cells that have undergone abnormal changes and are at risk of developing cancer. This test helps detect precancerous lesions or cervical cancer at a very early stage, allowing treatment before they progress further.
The procedure is carried out by taking a sample of cells from the cervix using a special tool, then the sample is examined in a laboratory.
Pap smears are performed annually after marriage or after becoming sexually active. Women between the ages of 30 and 65 can choose to:
- Continue to have regular pap smear tests every three years, or
- HPV DNA testing can be done every five years, or
- Undergo a combined Pap smear and HPV test every five years.
This test does not prevent HPV infection directly, but it is very effective in detecting changes in cervical cells early, so the risk of cancer can be significantly reduced.
The Difference Between the HPV Vaccine and the Pap Smear
Although both are important in preventing cervical cancer, the HPV vaccine and the Pap smear have different functions and methods. Here are the main differences:
|
Aspect |
HPV vaccine |
Pap smear |
|
Objective |
Prevent HPV infections that can trigger cervical cancer |
Monitoring for changes in cells in the cervical area that can trigger cancer. |
|
Period |
Ideal age 9-14 years, before becoming sexually active |
Starting at the age of 21 |
|
Method |
The number of injections can be two or three doses, depending on age. |
Taking a sample of cervical cells for analysis in the lab |
|
Frequency |
Children aged 9-14 years only need two doses, while individuals aged 15 years and above require three doses of the vaccine. |
Pap smear every 3 years (21-29 years), can be every 3-5 years (30-65 years) depending on the method |
|
Effectiveness |
Effective in preventing several types of cancer-causing HPV. |
Very effective in detecting abnormal cell changes early |
Should You Do Both?
The HPV vaccine and Pap smear should be administered simultaneously because they complement each other in preventing cervical cancer. The HPV vaccine prevents infection with the virus that causes cervical cancer, especially when administered early. However, this vaccine does not protect against all types of HPV.
On the other hand, Pap smears play a crucial role in early detection of cervical cell changes that could develop into cancer. Women aged 21 to 65 are recommended to have regular Pap smears.
By getting vaccinated and having Pap smears according to the recommended schedule, the risk of cervical cancer can be significantly reduced. Therefore, doing both is not only recommended, but also a crucial protective measure for the future of reproductive health.
Article written by Dr. Dewi Rochyantini, Sp.OG (Obstetrics and Gynecology Specialist, EMC Pekayon Hospital)