Cervical Cancer : The Cancer Killing African Women
Every two minutes around the world, a woman dies of cervical cancer. hence the need to talk about cervical cancer treatment becomes ambient likewise its prevention.
Cervical cancer is the fourth most common cancer in women worldwide and the second most common female cancer in women aged 15-44 years old worldwide. cervical cancer treatment despite scientific researches and awareness made on it, it is astonishing that this only preventable cancer (Cervical Cancer) is still causing such a high morbidity and mortality in Africa and other developing countries of the world.
What is Cervical Cancer
Cervical Cancer is a type of cancer that affects the lowest part of the uterus (womb). A woman is at risk once she clocks fifteen.
The primary causative agent is the Human papillomavirus (HPV) with the high-risk genotypes (HR-HPV) being responsible for the development of invasive cancer. Over 70% of all cases of cervical cancer are directly due to infection with HPV-16 and 18 strains thus making it the only human cancer whose necessary cause is known.
In 2012 there were an estimated 528,000 new cases of cervical cancer and 266,000 deaths from cervical cancer, with 70% of those deaths occurring in developing countries . In Sub-Saharan Africa, cervical cancer accounts for 22.5% of all cancer cases in women, and the majority of women who develop cervical cancer live in rural areas . Eastern Africa is one of the most heavily affected areas with an incidence of more than 30 cases per 100,000 women per year
In 2017, the World Health Organisation (WHO) reported that the number of Nigerian women suffering from cervical cancer annually totalled 14,089 making it the second leading cause of cancer deaths. Sadly, this statistics is not only high in Nigeria. Up to 530, 000 cases and 275,000 deaths are recorded in developing nations every year. Put together, this is 80% of the cervical cases in the world. This is quite unfortunate knowing that this type of cancer can be avoided before it becomes full blown.
Current estimates indicate that every year nearly one thousand women are diagnosed with cervical cancer and almost 700 die from the disease
Cervical Cancer ranks third among the most common cancers affecting women all over the world with an estimated 529,000 new cases in 2008, 85% of which were recorded in the developing world . Cervical cancer contributes to 20 to 25% of all cancers among women in sub-Saharan Africa, about twice the percentage in women worldwide. In spite of the fact that cervical cancer is preventable, the incidence is expected to increase to almost double the current rate by 2025 . Cervical cancer continues to cause the deaths of almost 270,000 women worldwide each year.
In Nigeria, cervical cancer kills one woman every hour and over 9000 women every year . More than three-fourths of cervical cancer patients are diagnosed at advanced stages leading to poor prospects of long-term survival and cure. This is due to the non-existence of a national screening programme, lack of infrastructure, poorly trained health staff and huge financial cost. It evidently constitutes a huge public health burden as the attendant loss of lives is needless due to its preventable nature. Screening is currently viewed as the most effective approach for cervical cancer treatment , control and it is associated with reduced incidence and mortality from the disease .
Factors linked to cervical cancer include but not restricted to the following:
Several key risk factors for cervical cancer are common in sub-Saharan, west African countries and the world at large , this includes
- prolonged HPV infections and HIV/AIDS which is endemic in this region (UNAIDS report 2012).
Other risk factors include
- Debut of sexual activity before age of 20 years old
- Multiple sexual partners,
- Tobacco smoking
- Oral contraceptive pill use for more than 5 years
- History of cervical cancer in the family
- High parity (more than 3 children born), and
- Immune-depression due to malnutrition or other systemic diseases .
The Human Papillomavirus (HPV) is the most common sexually transmitted infection. This infection is so widespread that 79 million Americans have this infection. Over 35 out of the 100 types of this infection can get into a woman’s vagina, cervix, the anus, a man’s penis, and scrotum, the mouth and throat. Men who have been diagnosed with head and neck cancer because of this has increased in recent times. It takes about 10 to 30 years before it becomes developed. Hence the need for a pap smear screening every three to five years irrespective your sexual status.
Sexually active women who started at a young age have a high risk of getting this cancer.
It has been said countless times that smoking is more dangerous than we imagine, yet the nicotine in it makes us addicted. Besides lung cancer, smoking increases the chance of having cervical cancer by double.
Quite a number of women who have a weak immune system are prone to cervical cancer.
This synthetic form of estrogen is a leading cause of cervical cancer. Women whose mothers took this drug are likely to get cervical cancer.
Women who have been diagnosed usually have about five years to live yet this preventable cancer can be diagnosed with Pap smear screening and HPV vaccine. Unfortunately, over 75% of women diagnosed with cervical cancer have never had a pap smear done before.
The pap smear is painless and is carried out by an obstetrician-gynaecologist. A pap smear test is recommended for sexually active women between the ages of 21 to 65. After the speculum is inserted into the vagina, the cells collected are placed under a microscope to test for cancerous tumours. If a woman bleeds excessively, it signals a problem. However, there are exceptions. Quite a few number of women who have cervical cancer have undergone a pap smear screening.
Although there are debates on if a virgin should go for a pap smear or not, we recommend you consult your doctor.
Cervical Cancer Treatment
There are various forms of cervical cancer treatment ; Screening is currently viewed as the most effective approach for cervical cancer control and it is associated with reduced incidence and mortality from the disease.
In low resource countries, cytology-based screening programs and/or DNA typing of HPV are usually beyond the capacity of many health services. Visual inspection of the cervix using acetic acid (VIA) or Lugol's iodine (VILI) to highlight precancerous lesions allows identification of pre-cancerous lesions in the clinic instead of the laboratory. With adequate training, any health care provider, including doctors, nurses, or nurse-midwives, can effectively perform the procedure . Different studies have demonstrated that using VIA, trained physicians and other providers correctly identified between 45% and 79% of women at high risk of developing cervical cancer.
Conventionally, Pap smear, combined with treatment of cervical pre-cancerous lesions and early-stage cancer, has been successful in preventing up to 80% of invasive cervical cancer cases in the developed world. In developing countries, however, high rates of cervical cancer mortality still persist due to lack of effective screening programs and low uptake of Pap smear testing. Newer technologies such as the HPV/DNA test (QIAGEN, Gaithersburg, MD, USA), cervicovaginal self-sampling, and HPV vaccination have the potential to increase screening and reduce cervical cancer in developing countries .
However, awareness about new screening and cervical cancer prevention methods remains low among most women, with studies recording almost no awareness of HPV infection, HPV screening and adolescent vaccination for the prevention of future disease in rural areas.
- Cervical cancer continues to be a public health problem in Africa, but screening using VIA (Visual inspection of the cervix using acetic acid) is practical and feasible even in rural settings. Implementation of cervical cancer screening in all eligible women should be a national priority.
- Parents are advised to vaccinate their daughters against cervical cancer.
- Attempts to reinforcing the knowledge of cervical cancer and correcting the wrong perceptions towards cervical cancer prevention will have a positive influence on its practice and furthermore assist all stakeholders in the health sector to work together to establish a national programme for cervical cancer treatment, screening and vaccination.