Preventable cancer shouldn't kill any more

When a 26-year-old woman’s life takes a difficult and painful turn because of her stage 4 cervical cancer diagnosis, it is heart-wrenching. As a doctor, it makes me ask myself, what am I not doing right to save her?

Cervical cancer is preventable but we are not doing enough to get women the preventive medical care. There is a need to create awareness that this particular cancer need not kill anyone or so inhumanely rob a woman of her dignity.

CERVICAL CANCER

In 99.7 per cent of cervical cancer, Human Papilloma Virus (HPV) is the causative agent. There are over 100 types of HPV.

Of these, 15 types are known to be high-risk in causing cervical cancer. One way of prevention is by vaccination, which can protect against the two main types associated with causing 70-75 per cent of cervical cancer globally.

Girls aged 11-12 years but as young as nine can receive two doses of the vaccine and acquire 70 per cent protection.

Older women can also be vaccinated in that, even if they are sexually active and have been infected by one strain, they would be protected against the other. Age 15-26 would require three doses.

Rigorous screening is the mainstay of arresting cervical changes before they become full-blown cancer. Even the women and girls who are vaccinated still need to undergo routine screening as the vaccine confers immunity to only about two strains that cause 70 per cent of the cancer cases but there are still another 13.

GOOD IMMUNITY

It takes time from the time of persistent infection with HPV to develop cancer in women with good immunity.

In the immune-compromised, it takes much shorter. Unfortunately, there are no signs to alert a woman that she is developing cervical cancer until it is already full-blown.

African women are increasingly dying of cervical cancer mainly due to lack of preventive health education and also medical insurance for screening, as well as stereotypes that prevent them from seeking help early for fear of labels such as ‘bewitched’ or ‘outcast’.

According to the World Health Organization (WHO), cervical cancer is the most common in Africa, accounting for 22 per cent of all female cancers and 12 per cent of newly diagnosed cancer in men and women yearly.

Every year, 34 out of 100,000 women are diagnosed with cervical cancer and 23 of 100,000 die from it; 33 per 100,000 in Kenya have it and 22 per 100,000 die from it.

3,200 WOMEN DIED

Compare that to seven out of 100,000 diagnosed with the disease and three of 100,000 dying of it in North America.

In Kenya, eight women die of cervical cancer every day with 5,250 new cases diagnosed last year, when more than 3,200 women died of the disease.

It is time Kenya invested in preventive medicine for both men and women. The government should hasten introduction of free HPV vaccines for girls from nine years. Secondly, we need to start talking about this menace in our social settings to demystify it and create awareness by giving knowledge and stressing that it is preventable and, if diagnosed early, curable.

Women should be supported and encouraged to undergo the Pap smear test yearly and also other screening methods. Universal health coverage should ensure all health facilities are properly equipped with infrastructure and manpower.

Lastly, have all women easily access screening and vaccines.

Dr Wakahe is a consultant obstetrician/gynaecologist based in Nairobi. [email protected] @JaneWakahe