#Allin4health #health4all #Minding your wellbeing #cervical cancer awareness
By Dr T.W Ngwenya Changamire
We are in the month of cervical cancer awareness. This is the month where we heighten our efforts on raising awareness on what cervical cancer is and the impact of this disease is affecting our communities.
The world health organisation states that Cervical cancer is one of the leading cancer related cause of death in women with an estimated 270000 deaths annually.
Of these deaths 85% are occurring in Africa.
Cervical cancer disproportionately affects poor countries and the 5 leading countries worst affected are Malawi, Mozambique, Comoros, Zimbabwe and Zambia according to UNICEF.
In Zimbabwe Cervical cancer mortality is currently sitting at 64% and there is need to reverse this and according to the Zimbabwe cancer research fund the country has the 5th highest burden of cervical cancer in the world. South Africa also has high incidence rates of Cervical cancer.
Cervical cancer is the second prevalent cancer following Breast Cancer.
Cervical cancer is abnormal growth of cells of the cervix. The cervix is the most lower part of the uterus that connects to the vagina. These abnormal cells replicate quickly and can invade and spread to other parts of the body.
Human papilloma virus (HPV) infection is linked to the development of cervical cancer.
There are various strains of HPV. Some HPV strains cause genital warts and other strains increase your risk of developing cervical cancer, penile, anal, vaginal and vulva cancers. When infected with HPV the immune system is affected and the body’s ability to prevent development of cervical cancer is reduced.
Other risk factors for cervical cancer are HIV infection because it weakens the immune system, early sexual debut, having unprotected sex with multiple partners, having sex with a man with multiple sexual partners, smoking and STI infection.
During the early stages of cancer, no symptoms will be present.
This is why screening is important. Screening will help to detect infection by the causative agent HPV and it will also help to detect abnormal changes in the cells of the cervix before they become cancerous, grow larger and possibly spread to local structures. As the disease progresses the following symptoms may develop and different women will experience different symptoms.
These symptoms signal that cancer has begun to grow. Symptoms include irregular vaginal bleeding, or postmenopausal bleeding, abnormal vaginal discharge which may be watery or bloody, vaginal odour, pain during sexual intercourse or pelvic pain.
As the cancer further progresses other symptoms like weight loss, abnormal bowel function, urinary incontinence and anaemia may develop.
Stages of cervical cancer
Staging of cervical cancer depends on how far the tumour has grown into the cervix, if the nearby structures are affected and if the cancer has spread to nearby lymph nodes or distant organs.
Briefly Stage 1 means growth affecting the cervix only, Stage 2 means the cervix and uterus are involved, Stage 3 means that the cervix, uterus and lower part of the vagina are affected and might also have involve surrounding lymph nodes, stage 4 means that the cancer has now grown into the bladder or rectum or distant organs beyond the pelvic area like bone, lungs and distant lymph nodes.
Prevention of cervical cancer
HPV vaccination: may reduce your risk of cervical cancer. Best vaccination outcomes are when people get vaccinated before HPV infection. This is why vaccination has been introduced to school-going children from the age of 9 years. 2 types of vaccines are available.
The one type is administered to both girls and boys. This is because HPV infection also affects boys. It is also expected that vaccination of boys will also decrease the HPV transmission rates. The other vaccine is administered to girls only. HPV vaccination programme was introduced in SA in 2014 and in Zimbabwe it was introduced in 2018 for girls aged between 10 and 14 years.
Screening: Routine pap smear investigations are advised in women who have started to engage in sexual activities. There are other screening methods like VIA (Visual inspection with acetic acid). Both these procedures detect pre-cancer changes. The HPV test will detect infection by the virus. A positive test only confirms infection by the HPV virus but does not confirm presence of cancer cells.
In the government 3 screening tests are advised in a space of 10 years for low-risk women.
Practicing safe sex practices: take measures to reduce STI infection by limiting the number of sexual partners and by using a condom every time you engage in sex.
When to see your doctor
It is important to visit your medical doctor for screening and risk assessment. Also get screened for STI’s and for HIV as these increase your risk further for cervical cancer. Women below 21 years are advised to screen if they are sexually active or if HIV positive.
Women between the ages of 21 and 65 are advised to screen every 3 years. Women over 65 years if HIV negative and have had 3 negative pap smears in the past decade are low risk and do not need to get screened.
Book an appointment also when you develop any of the symptoms mentioned above. Early detection saves lives. If the cancer is caught at an early stage it is possible to get cured and prevent further spread to other organs.
Cervical cancer is treatable by medical professionals. Treatment includes chemotherapy and may also include radiation and surgery depending on the stage of the cancer.
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