LETTER | The cervix is the lower portion of the uterus. Cervical cancer develops when normal cells in the cervix transform into abnormal cells and grow rapidly uncontrollably.

Cervical cancer is the fourth most common cancer in women worldwide and the fourth leading cause of cancer death. In 2020, cervical cancer caused 604,000 new cancer cases and 342,000 deaths worldwide.

In Malaysia, cervical cancer is the third most common cancer diagnosis in women. The risk over a lifetime was one in 144. The Chinese had the highest rate of occurrence, followed by Indians and Malays. A total of 41 percent of cervical cancer were detected at a late stage (III & IV).

The human papillomavirus (HPV) is responsible for more than 90 percent of cervical cancer cases. However, most people who have had HPV infections do not develop cervical cancer. Other risk factors include smoking, birth control pills, beginning sex at a young age, multi pregnancy, and multiple sexual partners.

Cervical cell screening for cervical pre-cancer using Papanicolaou smears (Pap smears) has significantly lowered the number of cases and deaths from cervical cancer. When cervical cancer is detected and treated early, most prognoses are well.

Cervical cancer may not exhibit any symptoms at first. When it does cause symptoms, it can result in vaginal bleeding, especially after menopause, in between menstrual cycles, after sexual intercourse. 

Non-cancer conditions can also cause these symptoms. However, if you experience vaginal bleeding during these times, please consult a doctor as early as possible. 

Pap smears combined with HPV vaccination and a nutritious diet can cut the risk of cervical cancer.

According to the World Cancer Research Fund Report in 2018, being overweight might increase the risk of cervical cancer. Being physically active and practising a healthy lifestyle are recommended. 

Limit consumption of energy-dense/high-energy food, including deep-fried foods, fast food, other processed foods, red meat, chips, snacks, dipping sauces, and limit sugar or high-calorie drinks including sweetened juices and alcohol. 

On the other hand, high-fiber fruits, vegetables, nuts, fish, legumes, and cereals are encouraged to reduce cervical cancer risk. 

Current research is addressing nutritional influences on HPV infection and cervical cancer progression. A healthy diet plays an essential role in preventing cervical cancer and protecting against HPV infection. 

High-fiber foods, including wholemeal grains, fruits, and vegetables high in antioxidants, potentially help prevent such cervical cancer.

DR SOH YIH HARNG and DR HAZREEN B ABDUL MAJID are from the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.