September is Cervical Cancer Awareness Month and Right to Care encourages women to go for screening.
“Cervical cancer is the most prevalent cancer for women in South Africa but it is also the most preventable and yet too many women are being diagnosed too late,” said Right to Care’s cervical cancer programme manager, Dr Bridgette Goeieman.
In South Africa, 8 000 new cervical cancer cases are diagnosed annually and more than 4 000 cervical cancer deaths occur every year.
Despite these alarming statistics, cervical cancer is the most preventable cancer.
It can be effectively treated if detected early but the public healthcare system currently does not have the capacity to roll out screening and treatment programmes on the scale that is required. In South Africa, women aged 15 years or older are at risk of cervical cancer.
Risk factors for cervical cancers include becoming sexually active at an early age, having multiple partners, smoking, using oral contraception from a young age, an unhealthy diet that is low in fruit and vegetables, sexually transmitted infections (STIs) and HIV.
The primary underlying cause of cervical cancer is the human papilloma virus (HPV), which is the most common STI, and of which there are more than 100 types.
Type 16 and type 18 cause 70 per cent of cervical cancers.
Prevention
Prevention includes screening, through pap smears, delaying sexual activity for as long as possible, and the use of condoms by those women who are sexually active.
There are currently two vaccines which protect against both HPV 16 and 18. They work best if administered before exposure to HPV.
Therefore, it is preferable to administer them before first sexual activity.
“The government is rolling out a vaccination programme in schools for girls aged nine to 13. It is encouraging to see efficient vaccine delivery with high uptake at schools in KwaZulu-Natal, Gauteng and the Western Cape,” said Dr Goeieman.
The HPV vaccination does not replace cervical cancer screening.
The goal of screening is to find cervix cell changes and early cervical cancers.
Without screening the cancer is often not identified until it is advanced and symptoms develop.
Dr Goeieman said that cultural issues and traditional beliefs are also hampering prevention efforts.
“There is a lot of scepticism about a young woman ‘having her private parts examined’.”
Parents also refuse to sign the standard indemnity forms for the vaccine because they believe it will make their daughters infertile, which is totally untrue.
A comprehensive approach to cervical cancer prevention and control is required.
“It should be multidisciplinary and encompass community education, social mobilisation, screening, vaccination, treatment and palliative care. Communication with schools, teachers, parents, girls and their communities’ needs to be scaled up,” said Dr Goeieman.
Symptoms of cervical cancer
These tend to appear only after the cancer has reached an advanced stage. They can include:
- Irregular, intermenstrual (between periods) or abnormal vaginal bleeding after sexual intercourse.
- Back, leg or pelvic pain.
- Fatigue, weight loss, loss of appetite.
- Vaginal discomfort or odorous discharge.
- A single swollen leg.
