CERVICAL CANCER: Regular Screening, Aid To Early Detection

Cervical cancer is a cancer affects the cervix (lower part of the uterus). It is due to abnormal growth of cells that have the ability to invade or spread to other parts of the body.

According to Dr. Femi Olaleye, Medical Director of Optimal Cancer Care Foundation, the cancer is a deadly disease, which has killed a lot of women in Nigeria and the world over.

On what causes cervical cancer, Olaleye said that it happens when cells in the cervix (situated at the neck of the womb) are influenced by some external factors to become abnormal and grow out of control. “The main causative factor was identified just as recently in 1992 by scientist as a virus named Human Papilloma Virus (HPV). Women get infected with this virus through sexual intercourse. 46 per cent of women are infected within three years of sexual exposure and 80 per cent of women are at risk of infection during their lifetime.”

He added: “The abnormal changes induced by the persistent presence of HPV in the woman’s cervix can lead to cervical cancer and this process can take between five to fifteen years. Majority of women therefore do not have any symptoms during this early pre-cancerous stage and hence are not aware of the disease unless they go for cervical cancer screening.”

According to the expert, when symptoms do appear, they tend to be non-specific. Symptoms such as vaginal discharge, which can be offensive in odour and blood-stained in colour associated with irregular bleeding and bleeding after sexual intercourse can also be found in other gynaecological disorders. Olaleye stated that the symptoms become persistent and difficult to manage, when the disease has become established and therefore women should not wait for symptoms. They should attend regular screening to aid early detection.

Since sex is the main causative factor, the age on onset of sexual interactions is therefore important. Women who are exposed to sex at an early age, as early as teenage years, for example, could present with cervical cancer as early as late twenties and early thirties. “Traditionally, the disease was commonly seen in women just over 40, as they approach 50, but this demography is changing drastically with early onset of sexual intercourse as witnessed in young women of today.”

The stages of the disease are from one to four. Staging is used to describe the extent of the disease and its severity and prognosis to treatment, he explains. So the presence of the disease confined to only the cervix (stage one) is a better prognosis compared to stage two, where the disease can be found to have extended to the other parts of the womb (stage two); if the disease has extended outside the womb, but confined to the pelvis, it is Stage three and if the disease has spread to other organs beyond the pelvis, it is classified as Stage four.

Asked whether it is curable and if there can be a relapse, Olaleye said it is preventable, but being curable depends on the stage at which the disease was discovered. “Stage 1 is usually associated with total recovery and cure, while late stage disease is difficult to cure, adding that there may be recurrences (and death).”
On whether the disease is hereditary, Olaleye says, “No, unlike breast cancer, cervical cancer is not a genetically-linked disease.

He revealed that cervical cancer can be prevented through vaccination against HPV, targeting young girls and women (primary prevention) and through regular cervical cancer screening, targeting sexually-active women.
To help minimise the disease burden, a national cervical cancer screening programme needs to be established to safeguard the lives of women.

In the United Kingdom and other parts of developed world, cervical cancer is now a less common cancer due to the screening service instituted for women and vaccination of young girls. Developing countries, like Nigeria, are still witnessing a higher incidence of the disease. The disease claims on average, a Nigerian woman every hour, close to 10,000 lives annually.

On the lifestyle changes women should make to reduce the risk of cervical cancer Olaleye says, “Basically, since the Nigerian government is yet to establish a National Cervical Cancer Screening Program, women are advised to attend regular screening tests every two to three years (Pap smear or Visual Inspection with Acetic Acid). Optimal Cancer Care Foundation provides free screening for women on Fridays across two centres in Surulere and Alagbado. The website www.optimalcancercare.org would be very useful.

“Men and women are also advised to be less-promiscuous and reduce the number of sexual partners as the risk of HPV infection increases with the number of sexual partners. HPV cannot be prevented by common barrier methods useful for safe sex such as condoms.”

Parents should endeavour to vaccinate their daughters from age 10 before they become sexually active and these vaccines (taken in three doses over a period of six months) shall provide life-long immunity for girls as they mature into young women, thereby eliminating the risk of cervical cancer, Olaleye advised.