Cervical cancer is a major cause of cancer deaths in India. It is caused by the human papillomavirus (HPV) and other risk factors include multiple sexual partners, smoking, and low nutrition. Early detection through regular Pap smears can detect precancerous cells so the condition can be treated before it develops into cancer. Prevention includes limiting sexual partners, HPV vaccination, and regular screening. The HPV vaccine provides nearly 100% protection against HPV types known to cause cervical cancer if administered before potential exposure to the virus.

1. RAJKUMARI AMRIT KUR COLLEGE OF NURSING
HEALTH EDUCATION
ON
PREVENTION OF CERVICAL CANCER
SUBMITTED TO:-MRS SARITA SHOKANDA SUBMITTED BY:-MS VERSHA CHAUHAN
ASSISSTANT PROFESSOR MSc Nsg 1st
year

2. R.A.K.College of Nursing R.A.K. College of Nursing
IDENTIFICATION DATA
1) Name of the student teacher :- Ms. Versha Chauhan
2) Class : - M.Sc. (Nsg.) 1st Year
3) Subject :- Community health nursing
4) Topic :- Cervical cancer
5) Group :- Family
6) Venue :- OPD BLOCK,R.F.T.C,CHHAWLA
7) Language: - Hindi
8) Method of Teaching : - Health Talk
9) Previous Knowledge : - Group has basic knowledge of A.V AIDS
GENERALOBJECTIVES
At the end of the health talk the group will be able to:-
1. Define cervical cancer.
2. Enlist the causes and risk factors of cervical cancer.
3. Enlist the symptoms of cervical cancer.
4. To know the prevention of cervical cancer.
5. To know about HPV vaccination.

3. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING LEARNING
ACTIVITY
AV
AIDS
EVALUATION
1min To introduce the
topic.
INTRODUCTION
Cervical cancer has beaten breast
cancer as the leading cause of cancer
deaths in women in India; it kills
around 33,000 women every year in
India. Cervical cancer is known to
occur because of a virus called
the Human Papilloma Virus (HPV)
transmitted through sexual contact.
Bad local hygiene, too many
children, not enough spacing
between children, low nutrition
levels and early marriage all
contribute to the risk factors. The
high risk group includes girls who
have had premature sex as teenagers,
those who have had multiple
pregnancies or multiple sex partners
and don’t use contraceptives. The
disease remains asymptomatic for a
long time till it starts invading
neighbouring tissues.
Approximately 0.6 percent of
women will be diagnosed with cervical
cancer at some point during their
lifetime, based on 2012-2014 data. The
current estimates indicate
approximately 132,000 new
cases diagnosed and 74,000 deaths
annually in India, accounting to nearly
1/3rd
of the global cervical cancer

4. deaths. Indian women face a 2.5%
cumulative lifetime risk and 1.4%
cumulative death risk from cervical
cancer.
Rates are also high in developing
nations, where more than 80% of
cervical cancer cases occur.
Worldwide, cervical cancer is the third
most common cancer among women
and the second most frequent cause of
cancer-related death, accounting for
nearly 300,000 deaths annually.( 2013)
India has a population of
approximately 365.71 million women
above 15 years of age, who are at risk
of developing cervical cancer. ... At
any given time, about 6.6% of women
in the general population are estimated
to harbor cervical HPV infection.
Cervical cancer, mainly caused by
Human Papillomavirus infection, is the
leading cancer in Indian women and
the second most common cancer in
women worldwide. Though there are
several methods of prevention of
cervical cancer, prevention by
vaccination is emerging as the most
effective option, with the availability of
two vaccines.
1 min To define
cervical cancer.
DEFINITION
Cervical cancer is a malignant tumor
deriving from cells of the "cervix uteri",
which is the lower part, the "neck" of the
womb, the female reproductive organ.
Student teacher defines cervical cancer
with the help of charts.
CHARTS Define cervical
cancer?

5. 2 min To explain the
causes of
cervical cancer.
CAUSES OF CERVICAL CANCER
Some common causes of cervical cancer
are:
 Smoking.
 Family history.
 Sexually transmitted disease.
 Human papillomavirus (HPV).
 Intake of birth control pills.
 Having multiple sexual partners.
Student teacher explains causes of
cervical cancer.
CHARTS Enlist the causes of
cervical cancer?
2 min To explain the
risk factors of
cervical cancer.
RISK FACTORS
Here are some of the risk factors about
which every woman should be aware of.
 Human papilloma virus (HPV) infection
 Smoking
 Chlamydia infection
 Immunosuppression
 Intake of inappropriate diet
 Usage of Intrauterine device (IUD)
 Having multiple full-term pregnancies
 Pregnancy at a young age
 Poverty
 Use of hormones like Diethylstilboestrol
(DES)
 Family history
Student teacher explains the risk factors
of cervical cancer.
CHARTS Enlist the risk factors
of cervical cancer?
5 min To explain the
symptoms of
cervical cancer.
SYMPTOMS OF CERVICAL CANCER
In early stages (even in the precancerous
stages), cervical cancers usually do not
cause symptoms. Only during the later
stages of cancer is when one or more of
these symptoms may be noticeable:
Student teacher explains the symptoms
of cervical cancer.
CHARTS Enlist the symptoms
of cervical cancer?

6. Abnormal bleeding
Unusual vaginal bleeding is the symptom
most strongly linked to cervical cancer,
according to the American Cancer
Society, this could be bleeding after
intercourse or between periods. Heavier-than-
normal periods or bleeding after menopause are
also potential signs of cervical cancer,
Pelvic pain
Along with abnormal bleeding, The pain
could be diffuse, or it could show up in any
area of your pelvis. It could also range from a
sharp pain to a dull ache. Especially if the pain
is new or doesn't seem related to your
menstrual cycle, you'll want to let your doctor
know about it. Pain during sex or urination are
also warning signs
Strange discharge: A cloudy, foul-
smelling discharge is also a potential red flag.
"[The discharge] could also be watery, Of
course, there are many causes of abnormal
vaginal discharge that have nothing to do with
cancer. So don't freak out. Just talk with your
doctor.
Fatigue
We can add cervical cancer to the long list
of health issues that could make you
feel fatigued or sluggish. "This isn't the first
symptom to look for, but it could be present.
However, the above symptoms can also be
caused by infections or other health
problems. Hence, it is very important to
consult your gynaecologist.

7. 2 min To describe the
diagnosis of
cervical cancer.
DIAGNOSIS
The process of transformation of a
precancerous state to cervical cancer takes
approximately 10 years or more. During this
period, a simple test called Pap smear can
detect this precancerous state.
Pap smears are recommended for all
sexually active women, the test being
repeated at three yearly intervals if normal
and at 5 yearly intervals if both Pap smear
and testing for high risk strains of HPV are
negative.
VIA, a simple test, which basically consists
of applying vinegar to the cervix and then
inspecting it, can be easily administered by
health workers. In a landmark study by Tata
Memorial Centre, Mumbai, mass screening
of women was found to reduce the risk of
dying due to cervical cancer by a whopping
30 %. It is known that mass screening for
cervical cancer once in 10 years can reduce
the incidence of this disease by 60 %!
 PAP test
 HPV DNA test: - Like the Pap test, the
HPV DNA test involves collecting
cells from the cervix for lab testing.
 CT (computerized tomography) scan
 MRI (magnetic resonance imaging
scan)
 Pelvic ultrasound
Student teachers describes the diagnosis
of cervical cancer.
CHARTS Enumerate some of
the diagnostic test of
cervical cancer?

8. 2 min To discuss the
treatment of
cervical cancer.
TREATMENT
The affected area of the cervix can be
effectively treated by a gynecologist using
simple treatment methods. Here are some of
the treatment options for cervical cancer:
Precancerous changes in the cervix may be
treated with cryosurgery and laser surgery.
The treatment options for women with
cervical cancer are surgery, radiation
therapy, chemotherapy or a combination of
two or more of these methods.
Student teachers discusses the treatment
of cervical cancer.
CHARTS What type of
treatment is used for
cervical cancer?
2 min To discuss the
prognosis of
cervical cancer.
PROGNOSIS
When followed up and treated properly, pre-
cancerous conditions of cervical cancer are
completely curable. There is 92% chance of
a five-year survival for cancer that has
spread to the inside of the cervix walls but
not outside the cervix area. The five-year
survival rate falls steadily as the cancer
spreads into other areas.
Student teachers discusses the prognosis
of cervical cancer.
PPT What is the prognosis
of cervical cancer?
5 min To describe the
prevention of
cervical cancer.
PREVENTION
Here are a few things you can do to prevent
cervical cancer:
 Limit the number of sexual partners
Student teacher describes the prevention
of cervical cancer.
CHARTS What precautions to
be taken for
prevention of cervical
cancer?

9.  Quit smoking and avoid second-
hand smoke
 Always use condoms
 Schedule your Pap tests
 Follow-up on abnormal Pap smears
 Get the HPV vaccines
 Majorityof the women become
infected with HPV at some point in
their lives, soon after the onset of sexual
activity.
 The lifetime risk for genital HPV is 50–
80% and genital warts is approximately
5%.
 In women who undergo routine
screening, the risk of having an
abnormal Papanicolou (Pap) smear is
35%, CIN 20% and ICC is <1%
approximately.
 Both HPV Vaccination (Primary
Prevention) and Screening (Secondary
prevention) is important for prevention
of cervical cancer.
WHY VACCINATION IS THE BEST
FORM OF PREVENTION
 There is no clear evidence that barrier
methods of contraception, most notably
use of condoms, confer a protection
against HPV infection.
 Secondly, except for genital warts, the
infection is asymptomatic.

10.  Adherence to routine screening bythe
susceptible female population through
periodic Pap smears even in developed
countries has been unsatisfactory.
 In developing countries like India,
large-scale routine screening is difficult
to achieve.
DEVELOPMENT OF HPV VACCINE
HISTORY
 Recombinant DNA technologyis used
to express the L1 major capsid protein
of HPV in yeasts (Saccharomyces
cerevisiae), which self-assemble to form
emptyshells resembling a virus, called
virus-like particles (VLPs).
 The VLPs have the same outer L1
protein coat as HPV but contain no
genetic material.
 The vaccine uses these VLPs as
antigens to induce a strongprotective
immune response.
TYPES OF HPV VACCINE
 Two vaccines licensed globallyare
available in India; a quadrivalent
vaccine (Gardasil™ marketed by
Merck) and a bivalent vaccine
(Cervarix™ marketed byGlaxo Smith
Kline).
 Clinical trials with both vaccines have
used efficacyagainst CIN-2/3 and

11. adenocarcinoma in situ (AIS) caused by
HPV.
 These vaccines do not protect against
the serotype with which infection has
alreadyoccurred before vaccination.
GARDASIL
 Gardasil™ is a mixture of L1 proteins
of HPV serotypes 16, 18, 6 and 11 with
aluminum-containing adjuvant.
 Clinical trials with three doses at 0, 2
and 6 months in more than 16,000
women aged 16–26 years from five
continents, including Asia, have shown
100% efficacy.
CERVARIX
 Cervarix™ is a mixture of L1 proteins
of HPV serotypes 16 and 18 with AS04
as an adjuvant.
 Clinical trials with three doses at 0, 1
and 6 months in more than 18,000
women globallyhas shown 90%
efficacyagainst type 16/18- related
CIN-2/3 and AIS.
 Follow-up studies in a subset of
participants over 4–5 years showed no
evidence of waning immunity.
EFFICACY OF VACCINES
 Participants who were alreadypositive
to anyvaccine HPV types before

12. vaccination acquired protection against
disease caused byother vaccine types.
 Additionally, 99–100% efficacywas
reported against vaccine-type related
genital warts, vaginal intraepithelial
neoplasia and vulvar intraepithelial
neoplasia.
EFFICACY OF VACCINES
 Immunogenicitystudies in females
aged 9– 15 years showed antibodytiters
non-inferior to those aged 16–26 years.
 In a combined analysis of all
participants over 3 years and a subset
through 5 years, efficacyagainst
vaccine-HPV type disease was 95.8%
and efficacyagainst vaccine- type-
related CIN or external genital lesions
was 100%.
 Longer follow-up studies are under
way.
DOSAGE AND SCHEDULE
 The vaccine dose is 0.5 mL given
intramuscularly, either in the deltoid
muscle or in the antero-lateral thigh.
 It is available as a sterile suspension for
injection in a single-dose vial or a
prefilled syringe.
 HPV vaccines can be given
simultaneouslywith other vaccines
such as Hepatitis B and Tdap.

13.  At present, there is no data to support
the use of boosters.
DOSAGE AND SCHEDULE
 The recommended age for initiation of
vaccination is 9–12 years.
 Catch-up vaccination is permitted up to
the age of 26 years.
 A total of three doses at 0, 2and 6
months are recommended with
Gardasil™ or 0, 1 and 6 months with
Cervarix™ (minimum interval of 4
weeks between the first and the second
dose, 12 weeks between the second and
third dose and 24 weeks between the
first and third dose).
DOSAGE AND SCHEDULE
 If the HPV vaccine schedule is
interrupted, the vaccine series need not
to be restarted.
 If the series is interrupted after the first
dose, the second dose should be
administered as soon as possible, with
an interval of at least 12 weeks between
the second and third doses.
 If onlythe third dose is delayed, it
should be administered as soon as
possible.
SIDE EFFECT AND
CONTRAINDICATIONS

14.  The most common adverse reactions
are local reactions like pain (mild to
moderate) in 83%, swelling with
erythema in 25% and systemic adverse
effects such as fever in 4% of the
vaccinees.
 No serious vaccine-related adverse
events have been reported.
 The HPV vaccine is currentlynot
licensed for use in female patients
younger than 9 years or older than 26
years or for use in male patients.
SIDE EFFECT AND
CONTRAINDICATIONS
 It is contraindicated in people with a
historyof immediate hypersensitivityto
yeast or to anyvaccine component.
 The vaccine should be deferred in
patients with moderate or severe acute
illnesses.
 The vaccine maybe administered in a
sitting or lying down position and the
patient should be observed for 15 min
post-vaccination for syncope.
 The vaccine is not recommended for
use in pregnant women.
 Although it has not been causally
associated with adverse outcomes of
pregnancy, data are limited.
 Anyexposure to the vaccine during
pregnancymust be immediately
reported.

15.  Lactating women and
immunosuppressed female patients can
receive the vaccine.
 The efficacyand the degree of immune
response could be poor in the
immunosuppressed group.
HPV VACCINATION IN MALE
 HPV vaccine is not licensed for use
among males in India.
 Efficacystudies among males are under
way.  Australia is the first countryto
approve the quadrivalent HPV vaccine
in males (between 9 and 15years old),
and the vaccine was approved for
administration to males between the
ages of 9 and 26 years in other
developed nations.
8 min To discuss about
pap smear.
 Up to 80% of women diagnosed with
invasive cancer of the cervix have not
had a Pap smear in the past 5 years.
 Cancer of the cervix is largely a
preventable disease.
THE RISKS OF HAVING A PAP
SMEAR
 There are absolutely no known medical
risks associated with Pap smear
Student teacher discusses about pap
smear.
CHARTS
&
VEDIO
What is pap smear
and what are the facts
related to pap smear?

16. screening. (However, there are medical
risks from not having a Pap smear.)
 A woman may experience a small
amount of spotting (light vaginal
bleeding) immediately after a Pap
smear, but heavy or excessive bleeding
is not normal.
2 min To conclude the
topic.
CONCLUSION:
Human Papilloma Virus (HPV) vaccination is a
primary preventive measure (serotype-specific
with limited cross-protection) of carcinoma
cervix. A cost-effective second-generation
human papilloma virus (HPV) vaccine is
needed for many developing countries to
address various issues specifically linked to the
region. However, till such time, secondary
prevention through periodic cervical cancer
screening should be in place to use the existing
infrastructure and cost-effective screening
methods such as Pap smear and HPV DNA
tests. There is no risk of getting a human
papilloma virus (HPV) infection from the
vaccine as the vaccine does not contain live
virus. Human papilloma virus (HPV)
vaccination and regular screening are the most
effective ways to prevent cervical cancer.
Student teacher concluded the topic.
BIBLIOGRAPHY:-
1. BRUNNER & SUDDARTH’S, textbook of medical surgical nursing, 12th
edition, volume 1, page no. 1457-1459.

17. 2. https://pubmed.ncbi.nlm.nih.gov/28343836/
3. https://www.who.int/reproductivehealth/topics/cancers/en/
4. https://www.slideshare.net/DrArunKumarPandey2/epidemiology-of-cervical-cancer