Cervical cancer a nemesis to women

Charity Ruzvidzo

Despite the fact that cancer of the cervix is preventable, it is the commonest cause of death in women in Africa.

Health experts say in many parts of the continent, cervical cancers are not identified or treated until advanced stages due to insufficient access to reproductive health care services, effective screening and early treatment.

According to the World Health Organisation (WHO) cervical cancer is caused by the sexually transmitted human papillomavirus (HPV). It affects younger age groups as a result of early sexual activity, multiple sexual partners, and exposure to other sexually transmitted infections such as HIV.

It is a preventable disease.

Samuel Murape, a medical doctor in Harare, said most cases of cervical cases are detected at later stages due to lack of adequate information on the disease.

“Many women who are diagnosed with cancer of the cervix do not have access to information such as the importance of early screening. Zimbabwe has, however, tried to put in place Visual Inspection with Acetic Acid and Cervicography (VIAC), an efficient method that screens and offers treatment at the same visit,” he said.

Murape said cases of cervical cancer have been increased by the high numbers of people with HPV and HIV.

“The high number of women who are HIV and HPV positive increases the chances of a cervical cancer outbreak. It is essential to educate young girls especially those who are not yet sexually active to avoid multiple sexual partners and to use protection to prevent contracting viruses that lead to cervical cancer,” he said.

A research conducted by Oppah Kuguyo indicates the low number of  treatment facilities affects the fight against cervical cancer.

“2,270 women are diagnosed with cervical cancer in Zimbabwe annually .The burden and mortality rate of cervical cancer is most likely to be higher than those recorded in the national cancer registry because some cases go unreported in areas that have poor access to health facilities such as rural areas.

The burden of cervical cancer is still very high in Zimbabwe mainly as a result of late presentation of disease, poor screening, diagnosis and treatment facilities which is compounded by the very high HIV incidence,” read the report.

Kuguyo also states that it is important to conduct education and awareness campaigns to improve the knowledge, attitudes and perceptions of cervical cancer

“Knowledge about cervical cancer is varied among Zimbabweans, with some women from rural areas describing cervical cancer as  a dirtiness of the womb caused by sperm and some further alluding to the cause as vaginal preparations, multiple sexual partners, cold weather and witchcraft. This poor understanding along with the misconceptions of what cancer and cervical cancer is, leads to poor health seeking behaviour,” he said.

A snap survey by Southern Times indicated that most women do not acknowledge the importance of attaining early cancer screening.

“I have never found the need to go and get screened considering that l have never felt any anomalies. I am the breadwinner in my family and l don’t have the opportunity to leave my busy schedule and get screened,” said Mavis Gumbo  of Budiriro, Harare. Rumbidzayi Rupara, a Norton resident, said VIAC centres were not easily accessible to a large number of women.

“VIAC centres are currently located in major hospitals; this becomes a challenge for many women to access them. It will be more convenient if other VIAC centres are set up in clinics were people can easily get screened and treated without transport challenges,” she said.

The Ministry of Health and Child Care recently launched the Zimbabwe National Cervical Cancer Control and Prevention Strategy (ZCCCPS) (2017-2020) which is aimed at to reducing the incidence and mortality rate of cervical cancer patients by reducing human papillomavirus (HPV) infections, detecting and treating cervical pre-cancer lesions, and providing timely treatment and palliative care for invasive cancer.

Efforts have also been put in place to give HPV vaccinate to girls up to the age of 14.

Secretary for Health and Child Care Dr Gerald Gwinji is on record saying measures were already underway to protect the younger girls before they become sexually active.

“The strategy to reduce the risk of cervical cancer now includes HPV vaccination and, to work best, HPV vaccination must be given before sexual debut because that is when you can protect them.

“This virus is sexually transmitted, but the vaccine will not be available to older women in the public sector. So, if someone abstained even up to 24 years of age, the vaccine will still work as much as it would on an eight-year-old,” he said.

This exercise is not peculiar to Zimbabwe only as Lesotho and Rwanda have also since rolled out the vaccine nationally to all their young girls.

Global trends show that most cervical cancer high-risk countries in Africa are Malawi, Mozambique, Zambia and Zimbabwe.

Cervical cancer ranks as the leading cause of female cancer in Zimbabwe.

In 2015, Malawi had the highest rate of cervical cancer worldwide, estimated at 75.9 per 100,000 population.

According to the WHO, cervical cancer will kill more than 443,000 women per year worldwide by 2030, nearly 90 percent of them in sub-Saharan Africa.

Health experts note that this increase in cervical cancer incidences in Africa is now counteracting the progress made by African women in reducing maternal mortality and increasing longevity.

The case is, however, not similar in high-income countries, where cervical cancer ranks in the bottom half of all new cancer cases, below gallbladder, mouth and brain cancers.

November 2017
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