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Monday, 4 December 2017

CERVICAL CANCER

CERVICAL CANCER


Cervical Cancer is the most common cancer affecting women in developing countries with highest incidence in parts of Africa and Latin America. Approximately 500,000 new cases and 250,000 deaths are recorded each year.

Around the world, a woman dies of cervical cancer every two minutes.

Women in developing countries suffer disproportionately from the burden of cervical cancer and account for over 80% of cases.

It is the most common cancer in women in Northern Nigeria, second only to breast in the south.

Overall, it is the second most frequent cancer in women, after breast cancer, occurring most commonly in women over the age of 30 and is the second most frequent cancer among women in Nigeria after breast cancer, with an estimated 10,000 women dying of cervical cancer annually.

If current trends continue, by the year 2050, there will be more than one million new cases of invasive cervical cancer annually.

Human Papilloma Virus (HPV) 16/ 18 / 45 / 31 are responsible for 80% of invasive cervical cancers worldwide.

HPV is transmitted through sex, and it can cause an infection in the cervix (the neck of the womb).

This virus has a very high transformational effect on the epithelial cells of the cervix especially before the age of 18 years as this is the age where these cells undergo a transition to a more protective form of cell type.

Thus early age at first sexual intercourse is a great risk. Engaging with multiple sexual partners or a male partner with multiple previous sexual partners also heightens the risk for HPV infection.

Other risk factors include exposure to oral contraceptives for greater than 3-5 years and high parity.

The infection usually doesn’t last very long because your body can normally fight it, but an HPV infection can change cervix cells into pre-cancer cells.

Most cells with early pre-cancer changes go back to normal on their own and if detected can be treated. But if they are not found and treated, the pre-cancer cells can lead to cancer.

Cervical cancer screening is a method of preventing cancer by detecting and treating early abnormalities. Early detection and treatment can prevent 75 per cent of cancers developing but, like other screening tests, it is not perfect.

Early detection through screening and treatment of pre-cancerous lesions remains the best possible protection against cervical cancer. Evidence shows that utilization of screening for prevention is very poor in Nigeria (South-East, North-Central, South-West, North-West).

A summary from the colposcopy unit in the antenatal clinic at the University College, Ibadan, showed that only about 3,000 women were screened in the three year period from 2005-2007. Screening uptake was 81.6% in 2002 in England.

The lack of policy on cervical cancer screening, public awareness, network formation, commitment from the government and communities and less operational research has mitigated on the overall success in Nigeria and Africa.

The decline in cervical cancer incidence and mortality in the developed world is attributed to successful mass cervical screening strategies.

Women between the ages of 15 and 44 are the most at risk for cervical cancer.

Many of these women are mothers who will leave behind dependent children.

Although there are no statistics specifically for Nigeria, it is estimated that about 21.5% of women in the general population of the West African sub region have been infected with Human Papilloma Virus (HPV) at a given time, which is a significant risk factor for cervical cancer.

Of all the cancers, cervical cancer is the only one that has both an effective vaccine and screening program that can prevent disease and death.

Sadly, none of these are available to Nigerian women apart from in projects by Society for Family Health (SFH) and others. In a country as wealthy as Nigeria, this cannot possibly be acceptable.

While we build high speed trains, new airports and stadia, maybe it is time to refocus on the things that matter the most, the lives of Nigerian women.

Poor, rural women, who make up the majority of cervical cancer victims, are particularly unable to access screening and testing services.

Furthermore, women who are screened often can’t complete treatment or follow-up, citing unawareness of the significance of their symptoms, bad medical advice, or economic problems as main barriers to completion.

Because of the painful and dehumanizing death associated with the disease, women with cervical cancer are sometimes considered a ‘nuisance,’ and are left to die alone.

Overall, data suggest an urgent need for community screening and education programs to control and prevent cervical cancer.

Anthony Robbins says, “The only limit to your impact is your imagination and commitment.”

We must raise our level of commitment to securing the lives of our women from the ravaging scourge of this near to total preventable Monster.       
Dr. Hope Abraham Omeiza (MBBS, CPMP, ACPM)                                            [email protected]
08060810748


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