Studies from the World Health Organization (WHO) show that every woman sexually active woman is at risk of cervical cancer.
In recent times, statistics
available have shown that in Nigeria, cervical cancer accounts for 15 per cent
of female cancers as compared to just about 3.6 percent in the developed
countries. Shockingly, less than 0.1 per cent of Nigerian women have ever had
cervical cancer screening in their lifetime and less than 1 per cent is aware
of the existence of this silent killer. Consequently, cervical cancer kills a
woman every hour in the country. Although 100 percent preventable, the cancer
kills more women aged 24 to 35 years old women in developing countries than any
other cancer in other parts of the world.
The World Health Organisation (WHO) projects a 25 per cent increase over the
next decade in the absence of widespread interventions. This is a sharp
contrast to what obtains in countries like Britain which have national
screening programmes. There, deaths from cervical cancer have reduced by 75 per
cent and reducing by further 7 percent annually.
Unfortunately, according to WHO estimates, Nigeria has a population of 40.43
million women aged 15 years and older who are at risk of developing cervical
cancer. Current estimates indicate that every year 14,550 women are diagnosed
with cervical cancer and 9659 die from the disease. Worse still, Cervical
cancer ranks as the 2nd most frequent cancer among women in Nigeria, and the
2nd most frequent cancer among women between 15 and 44 years of age. About 23.7
per cent of women in the general population are estimated to harbour cervical
HPV infection at a given time and percentage of invasive cervical cancers are
attributed to HPV s 16 or 18.
Cervical cancer is one of the most common cancers
that affect a woman’s reproductive organs and various strains of the human
papillomavirus (HPV), a sexually transmitted infection, playa role in causing
most cases of cervical cancer. When exposed to HPV, a woman’s immune system
typically prevents the virus from doing harm. Thanks largely to Pap test
screening, the death rate from cervical cancer has decreased greatly over the
last 50 years.
Today, most cases of cervical cancer can be prevented with a
vaccine for young women In a study, Senior Lecturer/ Consultant at the Ahmadu
Bello University Teaching Hospital (ABUTH) Zaria, Dr. Marliyya Zayyan noted
that all Nigerian sexually active women are at risk of cervical cancer but the
risk of cancer of the cervix is reduced with male circumcision. She says cancer
of the cervix is the commonest malignancy among women in northern Nigeria.
Three to four new cases are diagnosed every week in ABUTH, Zaria “We had 203
cases of cervical cancer in 2007. This number represents 75 percent of the
total cases of confirmed gynecologic cancers presenting to the unit. The age
distribution was very wide and youngest age of presentation was 28 years and
the oldest was a 90year old with very advanced disease. The median age of
presentation is 35 years.
Majority of the women were married however 3 per
cent were single women who have never married and 20 per cent were divorced or
widowed. It affected family women with an average of 5 children.” Stating in
Nigeria cervical cancer patients present late, she said only four cases (1.9
per cent) out of 203 presented early enough for cure to be achieved. “For 98.5
per cent of cases the disease could best be palliated. “The early symptom of
bleeding after intercourse is often ignored by the patients.
Two hundred cases
were not possible to treat surgically. These cases were treated by heat
treatment (radiotherapy). A quarter of the patients presented with
complications of very late disease like leaking urine or faeces, or blockage of
their intestines or urinary flow” Challenges of management, includes deaths
from cervical cancer on poverty. “The cost per cycle of heat treatment is
N25,000 and six to seven cycles are normally required. Special drugs required
to melt out the cancer are very expensive and toxic. Could be unavailable.
Follow up of discharged patients is difficult. Many specialists are required to
effect treatment in the advanced stages patients present.” On the way forward,
“Cancer of the cervix is about the only human cancer that is almost entirely
preventable. “It is also 100 per cent curable if picked at very early stage.
Treatment is cheap and simple in early stages requiring minimal manpower to
achieve the high cure rate. Cancer of the cervix has an established screening
method that works. Today vaccines are available for primary prevention of
cervical cancer. Theses vaccines are already in use in other places and
technology for their production is known. Control of Cervical cancer depends on
increase in public awareness of the disease. Government should subsidies the
treatment and incorporate screening programme into the primary health care as
well as improve infrastructure and development of health facilities. To reduce
the burden, she posited that there should be constant training and re-training
of personnel. She recommended that “We need a strategy to reduce the burden of
disease in the community through education. We need to roll out a reliable
screening plan to cover at least 80 per cent of our population. The vaccine for
cervical cancer should be part of our immunization plan. We should get rid of
cervical cancer like other countries have done so we can direct attention on
other cancers that have more complex biology.
Overview of Cervical Cancer
Cervical cancer is one of the most common cancers that affect a woman’s
reproductive organs. Various strains of the human papillomavirus (HPV), a
sexually transmitted infection, playa role in causing most cases of cervical cancer.
When exposed to HPV, a woman’s immune system typically prevents the virus from
doing harm. In a small group of women, however, the virus survives for years
before it eventually converts some cells on the surface of the cervix into
cancer cells. Cervical cancer occurs most often in women over age 30. Thanks
largely to Pap test screening, the death rate from cervical cancer has
decreased greatly over the last 50 years. And today, most cases of cervical
cancer can be prevented with a vaccine for young women. At a glance In Nigeria,
cervical cancer is the second most common cancer in women after breast cancer
It accounts for 13 percent of all female cancers.
Overall, the mortality:
incidence ratio is 52 percent. There has been a steady rise in frequency of
cancer over the years. Cancers of the cervix (30.1 percent) topped the list of
the most frequent female cancers. Recent predictions of an increase in
incidence of cervical cancer is manifesting. Findings at the Kano Cancer
Registry, Ahmadu Bayero University, Kano, supports evidence for establishment
of comprehensive cancer control programmes. At a rough estimate, Nigeria
records 10,000 cases of cervical cancer yearly,” notes Prof. Isaac Adewole,
Consultant Obstetrician and gynaecologist at the College of Medicine,
University of Ibadan. “The women with this ailment die in a painful, miserable
and undignified manner. At least 80 per cent of cases in Nigeria are at
advanced stage where very little can be done.
Measures including prevention,
early detection and effective management of cervical are necessary to prevent
an increase in incidence and deaths of women from the disease. He said there is
need for stronger advocacy to ensure that cervical cancer vaccine becomes
available in the public health sector. Adewole, also principal investigator
Operation Stop Cervical Cancer Nigeria laments that cervical cancer fuels a
cycle of poverty. Most of these women are low income earners and often located
far from health institutions. The disease which affects the poorest and most
vulnerable women sends a ripple effect through families and communities that
rely heavily on women’s role as both providers and care givers.” Every 10
minutes, two women die from cervical cancer worldwide, affecting more of
younger productive women between 20 years and mid 30s.
Once a woman is
affected, it can take between five and 30 years for the virus to develop into
full cancer, but since it has no early symptoms, the woman feels very healthy
while the virus continues to ravage her. By the time the symptoms begin to
show, the situation becomes uncontrollable. Virtually nothing can be done to
remedy the situation and the woman waits for death. Cervical cancer has been
reduced drastically in the western world thanks to universal screening. “The rate
of the cancer in Nigeria is 70 per cent and rising. If we can introduce
universal screening, it would reduce drastically.” Symptoms Early cervical
cancer generally produces no signs or symptoms. This is why regular screening
is so important. As the cancer progresses, the following signs and symptoms of
more advanced cervical cancer may appear:
* Vaginal bleeding after intercourse,
between periods or after menopause
* Watery, bloody vaginal discharge that may
be heavy and have a foul odor
* Pelvic pain or pain during intercourse When to
see a doctor: If you experience any unusual bleeding between periods or pain
during intercourse, make an appointment with your doctor. Risk factors
* The
greater your number of sexual partners – and the greater your partner’s number
of sexual partners – the greater your chance of acquiring HPV.
* Early sexual
activity. Having sex before age 18 increases your risk of HPV.
* If you have
other STDs – such as chlamydia, gonorrhea, syphilis or HIV / AIDS – the greater
your chance is of also having HPV.
* A weak immune system. Most women who are
infected with HPV never develop cervical cancer. However, if you have an HPV
infection and your immune system is weakened by another health condition, you
may be more likely to develop cervical cancer.
* Cigarette smoking. The exact
mechanism that links cigarette smoking to cervical cancer isn’t known, but
tobacco use increases the risk of precancerous changes as well as cancer of the
cervix. Smoking and HPV infection may work together to cause cervical cancer.
Complications Treatments for invasive cervical cancer often make it impossible
to become pregnant in the future. For many women especially younger women and
those who have yet to begin a family infertility is a distressing side effect
of treatment. For a specific subgroup of women with early cervical cancer,
fertility-sparing surgery may be a treatment option. Causes In general, cancer
begins when healthy cells acquire a genetic mutation that turns normal cells
into abnormal cells. There are two main types of cervical cancer:
* Squamous
cell carcinomas begin in the thin, flat cells that line the bottom of the
cervix (squamous cells). Screening Most guidelines suggest beginning screening
at age 21, and some recommend starting within three years of becoming sexually
active, or no later than age 21.
*Pap test. During a Pap test, your doctor
brushes cells from your cervix – the narrow neck of the uterus – and sends the
sample to a lab to be examined for abnormalities.
* HPV DNA test. Your doctor
also may use a lab test called the HPV DNA test to determine whether you are
infected with any of the 13 types of HPV that are most likely to lead to
cervical cancer. Diagnosis Your doctor may examine your cervix:: During an exam
called colposcopy, your doctor uses a special microscope (colposcope) to
examine your cervix for abnormal cells.
Staging exams:
* Imaging tests. Tests
such as X-rays, computerised tomography (CT) scans and magnetic resonance
imaging (MRI) help your doctor determine whether your cancer has spread beyond
your cervix.
* Visual examination of your bladder and rectum. Your doctor may
use special scopes to see inside your bladder (cystoscopy) and rectum
(proctoscopy). Your doctor then assigns your cancer a stage. Treatments and drugs
Treatment of cervical cancer that’s confined to the outside layer of the cervix
typically requires treatment to remove the abnormal area of cells. For most
women in this situation, no additional treatments are needed. For Invasive
cancers Cervical cancer that invades deeper than the outside layer of cells on
the cervix is referred to as invasive cancer and requires more extensive
treatment. Treatment options may include: Surgery to remove the uterus
(hysterectomy) is typically used to treat the early stages of cervical cancer.
Hysterectomy can cure early-stage cervical cancers and prevent cancer from
coming back, but removing the uterus makes it impossible to become pregnant.
*
Radiation therapy uses high-powered energy to kill cancer cells.
* Chemotherapy
uses strong anti-cancer medications to kill cancer cells. Chemotherapy drugs,
which can be used alone or in combination with each other are usually injected
into a vein and they travel throughout your body killing quickly growing cells,
including cancer cells.
Prevention You can reduce your risk of cervical cancer
by taking measures to prevent HPV infection. HPV spreads through skin-to-skin
contact with any infected part of the body – not just during intercourse. Use a
condom every time you have sex in order to reduce your risk of contracting HPV.
Story By JOHNSON OKPUSA OBASI
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In recent times,
statistics available have shown that in Nigeria, cervical cancer
accounts for 15 per cent of female cancers as compared to just about 3.6
percent in the developed countries. Shockingly, less than 0.1 per cent
of Nigerian women have ever had cervical cancer screening in their
lifetime and less than 1 per cent is aware of the existence of this
silent killer. Consequently, cervical cancer kills a woman every hour in
the country. Although 100 percent preventable, the cancer kills more
women aged 24 to 35 years old women in developing countries than any
other cancer in other parts of the world.
Read more at: https://www.vanguardngr.com/2010/09/cervical-cancer-every-sexually-active-woman-is-at-risk/
Nigeria Natural
Health Online your No1 Natural Health Blog in Africa, has been nominated
for 2017 Fitness Health Blogs Awards. We need you to Vote for us in
order to bring this award home.
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