Ensuring equity in elimination of cervical cancer in Nigeria

Cervical cancer, which is the fourth most common cancer, is a kind of cancer that happens when cervical cells become abnormal and out of control over time. These cancer cells invade deep into the cervical tissue. If it progresses, cancer cells can spread to different organs in the body. According to WHO, in 2018, an […]

Cervical cancer, which is the fourth most common cancer, is a kind of cancer that happens when cervical cells become abnormal and out of control over time. These cancer cells invade deep into the cervical tissue. If it progresses, cancer cells can spread to different organs in the body.

According to WHO, in 2018, an estimated 570,000 women were diagnosed with cervical cancer globally and approximately 311,000 women died from the disease. In 2020, an estimate of 604,000 new cases and 342,000 deaths were also recorded. Cervical cancer cases are known to be associated with high-risk human papillomaviruses (HPV) infection. The virus is transmitted through skin-to-skin contact and additionally through sexual intercourse. This is the same virus that causes genital warts. There are over 100 different strains of HPV, however, HPV- 16 and HPV- 18 alone causes cervical cancer.

Most instances of cervical cancer are prompted by HPV infection. HPV is a virus that penetrates the cervical cells and changes them. Some HPV types are associated with cervical, vulvar, vaginal, penile, anal, mouth and throat cancers. The type of HPV that causes cancer are recognised as ‘’high risk types’’.  HPV is very common and without getting tested, people do not even know they are infected because early HPV infections often do not come with symptoms.

This also applies to cervical cancer as many Nigerian women with this disease do not realise early on because it, just like HPV, does not also cause symptoms until late in the disease and most times the  symptoms appear, they can easily be mistaken for common conditions such as menstrual bleeding or urinary tract infections (UTIs), back pain, bone fractures, fatigue, heavy vaginal bleeding, urine leakage, leg pain, loss of appetite, and pelvic pain.

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Very few women with HPV types are at high risk of developing cervical cancer. Most HPV infections clear up on their own because of the body’s natural ability to fight infections. When they are gone, the cells return to normal. In a minority of women, HPV infection persists for a long period of time, it is called a persistent infection. High risk types of persistent HPV infection can cause more severe changes in cervical cells and this changes that persist for one or two years are more likely to turn into cancer if left untreated

Many of us do not know how dangerous cervical cancer is and its symptoms being mistaken for something else makes it even more dangerous but then it can be prevented and this is where cervical cancer screening becomes very important. Cervical cancer screening is used to find changes in the cells of the cervix that could lead to cancer and this screening includes cervical cytology (also called the Pap test or Pap smear) and testing for human papillomavirus (HPV).

To maintain good health, it is important to have regular pelvic examinations. An important part of this pelvic examination is a test called a Pap smear to detect the life-threatening disease of cervical cancer before it starts. Early detection of cervical cancer increases the chances of treatment, prolongs survival, and improves quality of life. The good news is that even when it is diagnosed at late stages, it can still be controlled with appropriate treatment and palliative care.

Many Nigerian women do not know about this cancer.

It is, therefore, suggested that awareness of cervical cancer should be raised to educate women about the risks of untreated infection and women should be encouraged to go for periodic checkups. Cervical cancer prevention must be multidisciplinary, incorporating elements of community education, social mobilization, vaccination, screening, treatment. It is advisable for people who are of the age from 25 to 49 to carry out cervical cancer screening at least every three years and for people who are from the age of 50 to 64 to carry this screening out at least every five years because most cervical cancers develop between these ages. To be safe completely from cervical cancer it is important to keep getting tested until at least 65 years of age.

 

Claire Nwachukwu writes from the Centre for Social Justices (CSJ), Nigeria.