Myanmar Times
Burma
By Khin Myat and Yamon Phu Thit
Auguet 15 – 21, 2011
CERVICAL cancer is the second most common form of cancer in Myanmar women but medical experts are divided over whether to recommend vaccination for human papilloma virus, a sexually transmitted infection that is thought to be the major cause of the disease.
The two vaccines on the market prevent at least two types of HPV that are responsible for about 70 percent of all cervical cancer, according to their manufacturers. However, some experts are concerned that women who get the vaccination mistakenly think they are protected from all forms of the virus, which is the most common sexually transmitted disease.
Dr Soe Lwin, associate professor and consultant obstetrician and gynaecologist at Yangon Central Women’s Hospital in Landamadaw township, said there were more than 100 types of HPV and the vaccines were only able to prevent virus types 16 and 18.
“These are high-risk viruses, responsible for 70pc of all cervical cancer,” he said. “But the vaccination cannot prevent 100pc of cervical cancer cases.”
He likened HPV vaccination, which has been available in Myanmar since 2005, to wearing a helmet while riding a motorcycle.
“If we have an accident while riding a motorcycle, we can’t say for sure that we won’t die even if we wear a helmet. But we are less likely to die because we are wearing a helmet,” he said. “To prevent cervical cancer vaccination is not enough; self-protection is also needed. Young people should be given sex education once they are old enough.”
Women who get the HPV vaccination should still undergo an annual pap smear test, which can detect the warning signs of impending cervical cancer.
Cervical cancer is most commonly found in women who have sex at an early age, have multiple sexual partners, have a poor immune system, use birth control pills for a long time or smoke.
Symptoms include untimely bleeding, foul-smelling blood and pus and, if the cancer cells have spread throughout the body, backaches and bleeding during urination, he said.
“Women should have knowledge of the symptoms. Cervical cancer can often be cured if discovered early but many patients come to us too late,” Dr Soe Lwin said.
While he recommends young women get the HPV vaccination, not everybody in the medical fraternity is convinced.
Dr San Yee, also an obstetrician and gynaecologist, said it needed to be made clear to women considering vaccination that it only protects against two of the 23 “high-risk” forms of HPV.
“If this is explained clearly they can consider the effect of the vaccine and whether it’s worth spending money on,” Dr San Yee said. “Every woman should take a pap smear test regularly. Many other countries operate nationwide cervical cancer screening programs. If we want to protect women from cervical cancer, a national screening program should be introduced.”
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