Ending Cervical Cancer Within a Few Generations
Ending cervical cancer within a few generations
January is Cervical Cancer Awareness Month with the focus being on ending cervical cancer within a few generations. Cancer is an emerging health concern ranking third as the cause of death after infectious and cardiovascular diseases in Africa.
According to the Kenya Cancer Statistics & National Strategies, cervical cancer is the second most common cancer among women in Kenya with about 70 to 80% of these diagnosed in advanced stages. This is due to factors like lack of awareness, inadequate diagnostic facilities, lack of treatment facilities, high cost of treatment, and a high poverty index.
Cervical cancer is a type of cancer arising from a premalignant lesion within the cervix. The cervix is the lower narrow part of the uterus that connects to the vagina, and the vagina forms what can be termed as the birth canal.
Some of the symptoms of cervical cancer include:
- Abnormal vaginal bleeding
- Bleeding after menopause
- Malodorous discharge
- Pain during intercourse
With rare exceptions, cervical cancer results from genital infection with the human papillomavirus (HPV-mainly type 16 and 18) a known human carcinogen. HPV infections are caused by sexual contact. Some of the risk factors include:
- Early onset of intercourse
- Multiple sexual partners
- History of sexually transmitted diseases
- Immunocompromised state e.g. HIV, organ transplant recipients
- Lower socioeconomic status
- Smoking and alcoholism
Cervical cancer is treatable and preventable if detected early. It can be screened and prevented by vaccination, regular pap smear screening, and HPV screening.
Vaccination
HPV vaccination protects against the types of HPV that commonly cause cervical cancer as well as other cancers like vaginal, vulvar, penile, mouth and throat. The current recommendation for vaccination is for children aged between 9 and 12 years. Children and adults can still be vaccinated up to the age of 26.
Pap smears
This is the collection of cells from the surface of the cervix. They are then checked under the microscope for any precancerous or cancerous lesions. Doing regular screening can help detect any precancerous lesions early thus providing room for early treatment.
The American College of Obstetricians and Gynaecologists recommends screening for the following age groups:
- Women between ages 21-29 years- one pap smear screening every 3 years (although an annual checkup is highly encouraged).
- Women between ages 30-65 years- HPV screening and pap smear co-testing every 5 years. It is important to note that where HPV screening is not accessible women of this age group can still opt for a routine pap smear once every 3 years or at best annually.
- Women above the age of 65 years- no screening is recommended if adequate prior screening has been negative and high risk is not present.
What are the treatment options?
Some of the treatment options for cervical cancer include; surgery, radiotherapy, or chemotherapy depending on the stage. That is stage 1, stage 2, stage 3, or stage 4. Cancers diagnosed in advanced stages can be controlled with appropriate treatment and palliative care. With a comprehensive approach to preventing, screening, and treating, we can end cervical cancer as a public health problem within a few generations.
Author: Dr Francis Omari - Resident Medical Officer
