Testing, vaccination can help reduce cervical cancer cases

When you hear of cancer, grief and despair flood your thoughts, and rightfully so.

Having lost my father to cancer and later watched my mother battle and gallantly win against cancer, I know about this all too well. Cancer eats up healthy body cells, destroys normal body tissues, and compromises your overall health, making it deadly. In fact, it’s the second leading cause of death in the world.

Factors known to increase your risk of cancer include lifestyle choices such as smoking, excessive drinking, lack of exercise, poor diet, exposure to environmental carcinogens, and ingestion of toxic chemicals. But there’s good news. Over the years, survival rates among those diagnosed with cancer have been improving, thanks to advancement in cancer screening, treatment, management, and control.

As of 2020, cancer was the second leading cause of death worldwide with the types of cancer, incidence and mortality rates, and the burden of disease differing significantly between countries. Cervical cancer is the second most common female reproductive cancer after breast cancer, with nearly 90 per cent of the cases being reported in developing economies, according to the World Health Organisation.

Almost all cervical cancer cases are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through intimate contact. Although most infections with HPV resolve spontaneously and cause no symptoms, persistent infection can cause cervical cancer in women. Known risk factors associated with higher rates of cervical cancer include age at first birth, parity, number of sexual partners, use of oral contraceptives, and tobacco use. Also, women living with HIV are six times more likely to get cervical cancer than their peers, making this population of women an important group to prioritise for regular cervical screening.

According to the Gavi Alliance, the East African region has the highest burden of cervical cancer in the world. In Kenya, where HPV is the number one cause of cancer in women between the ages of 15 and 44, cervical cancer poses a great burden on women’s health due to the high incidence and poor prognosis, given that most women present when it is too late to prevent or treat the disease effectively.

The most effective method of preventing HPV is through vaccination of girls entering reproductive age. The WHO recommends HPV vaccination for all girls before 15 years of age to protect them from high-risk HPV known to cause cervical and other HPV-related cancers. A high uptake of HPV vaccination, along with regular screening and early diagnosis is attributed to the drastic reduction of incidence and mortality rates. Yet, today, uptake of screening is low with an increasing number of women presenting for treatment with advanced disease.

When diagnosed, cervical cancer is one of the most successfully treatable forms of cancer if it is detected early and managed effectively – although cancers diagnosed in late stages can also be controlled with appropriate treatment and palliative care. With a comprehensive approach to prevent, screen, and treat, cervical cancer can be eliminated as a public health problem.

Although surveillance programmes for cervical cancer for sexually active women and women of reproductive age are in place in Kenya, cervical cancer screening rates have remained relatively low, with some screening facilities significantly underutilised. While community awareness of cervical cancer in Kenya may have improved after the introduction of cervical cancer screening programmes in 2013 and HPV vaccination in 2019 in Kenya, the Kenya National Bureau of Statistics found that only 14 per cent of women of reproductive age participated in screening and nearly 50 per cent of women still presented with late disease.

Social factors such as lack of education, poverty, no access to condoms, or never having taken an HPV test have been known to significantly increase the odds of having low levels of awareness about cervical cancer. Other challenges leading to low uptake of cervical cancer screening services include fear of being diagnosed with the disease, long distance to the health facility, and shame of undergoing a vaginal examination.

Currently, HPV testing is the gold standard for screening but is not always possible to conduct due to financial and logistical reasons. To help save lives of women and girls, experts advise that cervical cancer screening needs to be available for those who have not been vaccinated to allow early diagnosis and treatment. To achieve this target, comprehensive community based cervical cancer awareness campaigns are needed so as to reach young women of lower socioeconomic status and upskill local health care providers with the appropriate skills, knowledge, and equipment to conduct screening and treatment of precancerous lesions.

We believe that this generation is key to setting the foundation for greater cervical health. Marie Stopes Kenya in collaboration with Kizazi Chetu, a cervical health awareness movement, are therefore, committed to supporting women throughout their health journey by providing much needed information to drive awareness as well as expert cervical cancer checkup, vaccination, screening and treatment through our network of care centres countrywide.