Cervical Cancer: How can it be screened and prevented

HEALTH & LIFESTYLE: Cervical Cancer is cancer that affects the lowermost part of the uterus; the cervix. It is caused by Human Papilloma Virus (HPV). 

Globally, cervical cancer is a health crisis impacting the lives of women and their families, most especially in developing countries. In 2020, it was estimated that 604,237 women were diagnosed with cervical cancer representing about 6.5% of all the cancers that affect females. 

Cervical cancer is also the most common cancer amongst women, particularly in sub-Saharan Africa. And it was estimated that about 341,843 women in 2020 were killed by cervical cancer, 90% of this figure were from developing countries where access to preventive information, screening, and treatment is grossly limited. 

Cervical cancer is the most common incident and mortal cancer amongst women in Uganda. Cervical cancer contributes to about 40% of all malignancies reported by Kampala Cancer Registry. Uganda estimates show that in 2018, about 6413 women were newly diagnosed with and 2400 succumbed to cervical cancer. It is projected that by 2025, Uganda will have about 6400 new cervical cancer cases and 4300 deaths annually.

Thus, the tragedy is still real, as of now, more women continue to die from cervical cancer. Research indicated that a woman diagnosed with cervical cancer is almost two times more likely to die than a woman diagnosed with breast cancer and those living with HIV are six times more likely to develop cervical cancer than HIV-negative persons. 

It is because of the above facts that every woman and school-going girl should get acquainted with cervical cancer, how it can be screened, and the preventive measures. 

Why screening for cervical cancer is important? 

Screening is used to detect pre-cancerous changes or early cancers before the signs and symptoms of cervical cancer can occur. This helps in reducing the number of people who die from cancer through prompt diagnosis and treatment. 

Detection of the precancerous changes usually involves any of the following tests;

1. PAP test. It is also called PAP smear, which allows for early detection of the changes in the cells that can lead to cervical cancer.
2. HPV test. This test detects the strains of Human Papilloma Virus (HPV) on a sample of cells removed from the cervix. The test can also be done on a vaginal sample and therefore women can also collect this sample on their own with instructions from a medical practitioner. 
3. Visual inspection with Acetic Acid (VIA). This test is important in areas where access to medical care is limited. In this test, a white vinegar dilution is applied to the cervix, the part of the cervix with precancerous cells will automatically change white. If the cervix is normal, there will be no observable change. 

How Can Cervical Cancer be prevented? 

• Regular Cervical Cancer screening is key in the prevention of cervical cancer. This is because early detection of the precancerous changes allows for prompt treatment before the condition progresses to the real cancer. 
• Receiving HPV Vaccine is also a useful factor in the prevention of cervical cancer. 

Other preventive behavioral measures include;

• Being faithful to one partner. This is important in reducing the risk of developing cervical cancer. 
• Stopping smoking also plays a vital role in preventing cervical cancer. 
• It is important to delay the first sexual intercourse until 18 years or older than that. 
• Practicing safer sex by consistently and correctly using condoms. 
• Avoiding sexual encounters with sex workers or people who have multiple sexual partners. 

In conclusion therefore we recommend that;

1. Cervical Cancer screening services are made available and accessible to the entire population even in the rural areas of Uganda. 
2. School going girls and women are vaccinated against HPV across the entire country. 
3. Women are constantly screened for HPV. 

The authors are; Oyaro Godfrey; a volunteer working with Lugazi School of Nursing and Midwifery and
Lilian Nuwabaine Luyima; BSc Nurse & MSN-Midwife & Women’s’ Health Specialist working with Aga Khan University as the CPD Coordinator & is the Heroes in Health Award Winner-Midwife of the year 2021