Cervical cancer is often spoken about in the context of diagnosis and treatment, but what is less discussed and far more important is the silent phase before cancer ever develops.
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Cervical cancer is often spoken about in the context of diagnosis and treatment, but what is less discussed and far more important is the long, silent phase before cancer ever develops. This pre cancer stage can last for years, sometimes even decades, quietly progressing without obvious symptoms. It is during these silent years that most opportunities to prevent cervical cancer are missed.
As a doctor working in a fertility hospital, I frequently meet women in their late 30s and 40s who come to us for fertility care or routine gynecological consultations. Many of them are educated, health-conscious, and proactive in other areas of wellness. Yet, a surprising number have never undergone a Pap smear or HPV test. The reason is simple: they feel well; they have no pain, no abnormal bleeding, and no visible warning signs. Unfortunately, cervical cancer does not announce itself early.
The long pre-cancer window
Cervical cancer does not appear overnight. It almost always begins with a persistent infection of the Human Papillomavirus (HPV), a very common virus transmitted through skin to skin contact. In most women, the immune system clears HPV naturally. However, in some cases, the virus persists and slowly causes changes in the cervical cells. These changes are known as cervical dysplasia or pre cancerous lesions.
This pre cancer stage can last anywhere between 10 to 15 years. During this period, the woman usually feels completely normal. There is no pain, no discharge, and no disruption to daily life or fertility. This is precisely why it is dangerous. It creates a false sense of security. By the time symptoms such as irregular bleeding, pelvic pain, or post coital spotting appear, the disease may have already progressed.
Why women miss early screening
One of the biggest myths surrounding cervical cancer is that it only affects older women or those with multiple pregnancies. In reality, any woman who has been sexually active is at risk. Another misconception is that screening is only necessary when symptoms occur. Cervical screening is not a diagnostic test for illness; it is a preventive test meant to catch abnormal cells long before cancer develops.
Cultural discomfort, fear of pain, lack of time, and simple unawareness also contribute to poorscreening rates. Many women prioritise family responsibilities, careers, and even fertility treatments, while silently postponing preventive care for themselves.
Early screening truly saves lives
Cervical cancer is one of the most preventable cancers when regular screening is followed. A simple Pap smear can detect abnormal cells early, and an HPV test can identify high-risk viral strains even before cell changes occur. When caught at the pre cancer stage, treatment is straightforward, minimally invasive, and highly effective. More importantly, early treatment preserves reproductive health, which is a critical concern for many women today.
In a fertility setting, we often emphasise that a healthy cervix is essential not only for preventing cancer but also for successful conception and pregnancy. Early screening protectsboth life and future fertility.
A message to every woman
The silent years before cervical cancer are not a waiting period, they are a window of opportunity. Screening does not mean you are unwell, it means you are responsible. It means choosing prevention over regret.
My message to every woman is simple, do not wait for symptoms. Do not assume you are tooyoung, too healthy, or too busy. Cervical cancer is largely preventable, but only if we act during the years when it is silent. Early screening saves lives and in many cases, it saves futures too.
Dr. Yasmin Imdad,
Sr. consultant obstetrics andGynaecology,
KinderWomen’s Hospital and Fertility Centre, Bangalore.