Cervical cancer is a major public health concern globally and the second leading cause of cancer morbidity and mortality among women in Kenya.
In Kenya, 16.2 million women of 15yrs and above are at a risk of getting cervical cancer. Statistics show that there are approximately 5,236 and 3,211 annual cervical cancer cases and deaths respectively.
Marked annually every January, cervical cancer awareness month encourages women to be more attentive to annual health checkups that would ensure early identification, testing and treatment.
What is Cervical Cancer?
This is a type of cancer that occurs in the cells of a woman’s cervix; the lower part of the uterus that connects to the vagina.
Almost all cervical cancer cases (99%) are linked to being infected with the high-risk Human Papilloma Virus (HPV), an extremely common virus transmitted through sexual contact.
By becoming more knowledgeable about this, women can detect any cancer related health issues at an early stage and get access to the best treatment.
Studies have shown that cervical cancer kills 260,000 women annually, and nearly 85% of these deaths occur in developing countries, where it is the leading cause among all types of cancer deaths among women.
Disparities in health and poverty play a large role in this high mortality rate.
Whereas routine Human Papilloma Virus (HPV) testing has dramatically reduced cervical cancer deaths in most developing nations, without proper health infrastructure, testing facilities and mass education on testing, the rates of cervical cancer in developing countries will remain high.
According to the World Health Organization, cervical cancer mortality rates have fallen in much of the developed world during the past 30 years, largely due to screening and treatment programmes.
However the rates in most developing countries have risen or remain unchanged, often due to limited access to health services, lack of awareness and absence of screening and treatment programmes.
Rural and poorer women living in low- and middle-income countries, as well as poorer women living in high-income countries are at an increased risk of contracting cervical cancer, because they often do not have access to crucial prevention, screening and treatment services.
Cervical cancer progresses slowly from the precancerous stage to invasive cancer and it is entirely curable if diagnosed and treated early.
The tragedy is that while this type of cancer is one of the most preventable forms of cancer, poor access to prevention, screening and treatment contributes to 90% of deaths.
When diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively.
Cancers diagnosed in late stages can also be controlled with appropriate treatment and palliative care. Like HIV, cervical cancer is a disease of health, gender and social inequalities for women and girls all over the world.
Services must therefore be expanded and integrated as an investment in the lives of women and girls and uphold their right to health.
To eliminate cervical cancer, WHO recommends that all countries must reach and maintain an incidence rate of below 4 per 100,000 women.
Achieving that goal rests on three key pillars of vaccination, screening and treatment and the corresponding targets.
That is; 90% of girls fully vaccinated with HPV vaccine by the age of 15, 70% of women screened using a high-performance test by the age of 35, and again by the age of 45 and 90% of women with pre-cancer treated & 90% of women with invasive cancer managed.
Each country should meet the 90-70-90 targets by 2030 to get on the path to eliminate cervical cancer within the next century.
Women and girls should be represented in the decision-making processes to set up national programs that offer quality services as part of improving their right to health.
All interventions for cervical cancer elimination should be placed within a health systems approach with people at the center of care.
HIV and sexual and reproductive health services are natural platforms for synergies with cervical cancer control. Immunization, health of adolescents, cancer control programs, primary health care, access to medicines and technology can also be strong enablers for implementing the elimination strategy.
For cervical cancer programs to be impactful, they must achieve adequate coverage, accessible and affordable. Implementation of the key cost-effective interventions as defined in the three pillars of the strategy require that programs work within a continuum of care so that women can be reached effectively throughout the life cycle.
Training is a key component to ensure quality programs, and screening for cervical cancer and treatment of precancerous lesions should be a mandatory competency for all healthcare personnel, especially those who are trained in gynecology.
All countries can make progress by implementing robust and cost-effective interventions aimed at eliminating cervical cancer and making it a disease of the past!