Cervical cancer is the most common cancer among African women, and is on the increase. Yet it remains a low public health priority. So how can women help themselves beat the disease if they are at risk?
When you Google ‘Cancer in Africa’ these are some of the article titles which come up on the first page: Cancer in Africa: Fighting a name- less enemy; Cancer in Africa is like a ‘runaway train’; Oncology: A Forgotten Territory in Africa – rather a gloomy picture. Cancer has such a mystical status in Africa that even with over 3,000 languages spoken across the continent, there is no vernacular word with direct translation for “cancer”. Although the incidence of cancer in Africa is increasing, it remains a low public health priority; resources are limited and there are other more pressing medical problems, such as Aids/HIV infection, malaria, and tuberculosis.
A Fabric of Africa Trends report shows that sub-Saharan Africa has the highest incidence of cervical cancer in the world. Cervical cancer is the most common cancer among African women, while breast cancer is the second most common, accounting for 16.8% of all female cancers. The highest incidence is in east Africa followed by Southern Africa.
Cervical cancer effects more than 11,000 women worldwide annually. Of the close to 2,000 Black women diagnosed with cervical cancer each year, over 40% will die. Yet cervical cancer is one of the most preventable types of cancer, and women can be screened for it with routine Pap tests. Cervical cancer is usually caused by genital human papillomavirus (HPV) infection. Cervical cancer may be prevented through the HPV vaccine or treated if detected early by a regular Pap test. If abnormal cells caused by HPV are found while they are still pre-cancerous, they can be treated before they progress into cancer.
No Signs or Symptoms
early cervical cancer generally shows no signs or symptoms. This is why regular screening is so important. A woman may develop symptoms only when the cancer has become invasive and spreads to nearby tissue. When this happens, the most common symptoms are: abnormal vaginal bleeding; unusual discharge from the vagina (separate from your normal menstrual period); bleeding following intercourse, douching, or after a pelvic exam; and pain during intercourse. And often by this time, it is already too late to treat.
Diagnosed Too Late
As much as 95% of cervical cancer patients in Africa are diagnosed at late or end-stage disease. The delayed diagnosis for these patients is due to the low level of cancer awareness among the population and health workers, culture and constraints on access to specialised care, which is usually nonexistent.
Most of the effort and help provided by western countries to Africa is spent on the prevention and cure of infectious diseases and malnutrition, leaving patients with cancer to their poor destiny. In fact, oncology in Africa seems to be a branch of medicine that is practised only by local traditional healers.
Based on surveys conducted by the Black Women’s Health Imperative in the united States, a majority of Black women are familiar with certain facts about cervical cancer how it is caused and that it is preventable. Yet Black women are still dying at a disproportionately higher rate. Although cervical cancer occurs most often in Hispanic women, Black women tend to have lower five-year survival rates than any other race and have twice the cervical cancer mortality rate compared to white women.
Provocative new research might help explain why Black women are so much more likely than whites to develop and die from cervical cancer: They seem to have more trouble clearing HPV, the virus that causes the disease. racial differences have been noted with HPV-caused cervical cancer, with African American women not only being more likely to develop this type of cancer, but also almost two times more likely to die from it, compared to european American women. estimated rates of death from the cancers in east and Southern Africa are from 30 to 60 deaths per 100,000 women, higher than in the rest of sub-Saharan Africa (20 to 35 deaths per 100,000 women). In uganda, it has been indicated that cervical cancer has become a leading cancer, claiming over 2,400 lives. Nearly 3,500 women have been diagnosed with it each year.
What You Should Do
“For the case of cervical and ovarian cancers, women need to be keen on their periods and discharge,” says Dr Lema, a renowned gynecologist in Kenya. “In case of any abnormality or persistent abdominal pains, they should go for a medical check-up im- mediately.”
If it is detected early, cervical cancer is one of the most successfully treat- able cancers. However, most women wait till the cancer is at its worst stage, when only palliative care can be given, hence the increased deaths from cervical cancer. And that is the bottom-line.
The American Cancer Society recommends that:
• All women should begin cervical cancer screening within three years after they start having sex and no later than aged 21. Screening should be done every year with a regular Pap test.
• Beginning at age 30, women who have had three normal Pap test results in a row may get screened every 2-3 years. Women older than 30 may also get screened every three years with either the conventional or liquid-based Pap test, plus the human papilloma virus (HPV) test.
• Women 70 years of age or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the past 10 years may choose to stop having cervical cancer testing.
• Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer testing, unless the surgery was done as a treatment for cervical cancer or pre-cancer.
• Women who have had a hysterectomy without removal of the cervix (a supra-cervical hysterectomy) need to continue cervical cancer screening and follow the guidelines above.