In recent times, research has shown that Sub-Saharan Africa, including Ghana, significantly contributes to all cervical cancer cases and deaths worldwide. It has become even more imperative to actively work together today to save mothers, sisters, wives, and friends from this preventable yet deadly condition. Cervical cancer is the fourth most common cancer among women globally and was responsible for 604,000 new cases and 342,000 deaths in 2020, according to data revealed by the World Health Organization (WHO).
Cervical cancer is a malignant tumor of the cervix, the lower aspect of the womb connecting it to the vagina. Human papillomavirus (HPV) is the most common cause, accounting for about 99% of all cases. This virus is almost exclusively transmitted through sexual intercourse but can also be spread through deep kissing, oro-anal, peno-anal routes, or the sharing of sex toys. It can be found around the skin close to the genitals, the genitals, and even in the mouth, depending on an individual’s sexual activity.
Women living with HIV/AIDS and not undergoing treatment are six times more likely to develop cervical cancer. Other risk factors for this condition include a weak immune system, long-term use of oral contraceptives, smoking, a family history of cervical cancer, having multiple sexual partners, as well as multiple deliveries. Cessation of smoking, practicing safe sex by using barrier methods like condoms, having one sexual partner (ensuring you are your partner’s sole sexual partner), and shortening the use of oral contraceptives can go a long way to reduce the risk of cervical cancer.
For every disease, prevention is key and saves lives, time, and money. Cervical cancer is no exception. The Centers for Disease Control advocate that at age 21, ladies should have their first HPV test or Pap smear done, after which the doctor will determine whether tests should be done every 3 or 5 years. These screening tests involve passing a speculum into the vagina to inspect the cervix and taking a sample for HPV screening or a Pap smear. By age 65, your doctor can decide with you whether there is a need to continue further testing. Typically, it takes about 15 to 20 years for cervical cancer to develop after HPV infection and 5 to 10 years in people with weak immune systems, especially women living with HIV/AIDS.
Currently, there are about six HPV vaccines available worldwide. WHO recommends that girls be vaccinated at ages 9 to 14, before they become sexually active. Healthy girls can receive a dose or two of the vaccine and those with weak immune systems will require two or three doses for protection. In an attempt to eliminate cervical cancer, the WHO came up with the ‘Global Strategy,’ which has targets to be achieved by 2030. Three targets state that:
– 90% of girls in all countries should receive the HPV vaccine by age 15.
– 70% of women should be screened with a high-quality test at ages 35 and 45.
– 90% of women with cervical disease should be receiving treatment.
If these targets are achieved, we can avert 74 million new cases and 62 million cervical-cancer-related deaths in years to come.
What are some symptoms and signs of cervical cancer? Cervical cancer can be asymptomatic in most cases, hence the need for screening. Other symptoms include abnormal vaginal bleeding, whether with duration or frequency, bleeding after sexual intercourse, foul-smelling vaginal discharge, and pain during sex.
It is noteworthy that even with the detection of HPV, there are several simple procedures that remove precancerous lesions. These include cryotherapy (freezing precancerous cells), thermal ablation (heat to destroy precancerous lesions), cold knife conization, and loop electrosurgical excision procedure (LEEP).
With cervical cancer, early detection is crucial to save lives. Depending on the stage of the cancer, surgery, chemotherapy (medication to kill or suppress cancer cells), radiotherapy (high-energy beams to destroy cancer cells), immunotherapy (empowering the immune system to kill cancer cells), or a combination of these can be used in the management of this condition. In advanced cases, palliative care is done to improve the quality of life of people with end-stage disease.
The fight against cervical cancer is not only for governments. It is a fight that starts with you, and the one close to you, and the entire world at large. Spreading the word today will save not only you but many other women who are yet to hear.
ARTICLE BY DR DELPHINA SEYRAM OBOUR