An estimated 570,000 women were diagnosed with cervical cancer globally, and over 300,000 women died from cervical cancer in 2018. Cervical cancer is the fourth most common cancer in women globally.
The prevalence and global distribution of cervical cancer reveal a troubling bifurcation, where survival rates are low and outcomes are poor among low socioeconomic groups who often have low levels of educational attainment, poor access to health services, especially screening and early detection.
Cervical cancer is emerging as a major public health challenge in sub-Saharan Africa where an estimated 372 million women over 15 years are at risk of developing the disease.
As a sexually transmitted infection, behavioural factors are important in the increased risk for Human Papillomavirus in high prevalence settings for HIV, where the two STIs tend to be synergistic. While most infections with HPV resolve and cause no symptoms, repeated infection can cause cervical cancer in women.
In Kenya, cervical cancer is the second most common cancer in women but the most common cause of cancer deaths. According to the World Health Organization 33 in 100,000 women are diagnosed with cervical cancer and 22 in 100,000 die from the disease.
But cervical cancer is a preventable disease. A proven way to prevent cervical cancer is screening. The HPV test is a reliable screening test, which looks for high-risk HPV that are more likely to cause pre-cancers and cancers of the cervix.
Screening tests provide the best opportunity to detect cervical cancer early when treatment is likely to be successful before pre-cancers turn into cervical cancer.
Finland launched a nationwide screening programme for cervical cancer in 1960, which led to a steep decrease in the rate of cervical cancer to less than one infection in 100,000 women by 1973.
However, despite the benefits of HPV testing, screening is rare, funding is scarce and quality is often low. Only a small number of women are screened, especially in Africa.
A recent study shows that only 16.4 per cent of eligible Kenyan women had been screened for cervical cancer in 2015. Often, only donors and NGOs fund the implementation of cervical cancer prevention and control strategies and in a very limited number of areas or regions.
There is evidence that increased vaccine coverage and HPV screening will greatly accelerate the decline in incidence of and death from cervical cancer. Rwanda was the first African country to launch a comprehensive national cervical cancer prevention programme that includes school-based vaccination of girls between the ages of 12 and 15 years together with diagnostic screening for women between the ages of 35 and 45.
Following in the footsteps of Rwanda nearly a decade later, Kenya’s President Uhuru Kenyatta launched an HPV vaccination campaign for girls aged 10 years in 2019, along with a raft of measures to enhance diagnostic screening for HPV.
We can eradicate cervical cancer and the needless suffering and death that it causes among women in Kenya and in sub-Saharan Africa. Hence, we must invest public health resources accordingly.
Alex O. Awiti is Vice Provost at Aga Khan University. Views expressed are the writer’s
