The revelation by the World Health Organisation (WHO) that 76,000 African women lose their lives yearly to the cervical cancer calls for a multi-sectoral approach to solve the problem. The WHO Regional Director for Africa, Dr. Matshidiso Moeti, who disclosed the casualty figure recently, described the loss of African women to the preventable disease as ‘unjust and unacceptable.’ She also emphasised the need to accelerate efforts to eliminate cervical cancer as a public health concern.
Cervical cancer, according to medical experts, is a persistent infection with high-risk types of human papillomavirus causing virtually all cervical cancers. There are two high-risk types, HPV 16 and HPV 18, both of which account for 70 per cent of cervical cancers worldwide. Most HPV infections disappear on their own within a year or two as the immune system controls the infection. Unlike these short-term infections which cause cancer, a high-risk HPV infection lasts for years. The National Cancer Institute, USA, says it can lead to changes in the cervical cells, resulting in a precancerous lesion. And if the precancerous lesion is not found and removed, it may eventually develop into cervical cancer.
The finding that nearly all sexually active people will become infected with HPV at some point in their lives explains why all hands should be on deck to tackle the prevalence of cancer in Africa. Nigeria accounts for a high proportion of cervical cancer cases and deaths in Africa. A 2023 report said Nigeria had a population of 60.9 million women aged 15 and older at risk of developing cervical cancer. Each year, approximately 12,075 Nigerian women are diagnosed with cervical cancer and 7,968 die from the disease.
The high number of deaths from cervical cancer in Nigeria is a cause for concern. Vigorous campaigns should be mounted on the causative factors of cervical cancers on radio, television, newspapers and social media in English, Pidgin and indigenous languages. Health centres and other direct communication channels should be explored at the community level to create more awareness on cervical cancer.
It has been established that women who become sexually active before 18 or have multiple sexual partners are more prone to become infected with a high-risk type of HPV. Research shows that some risk factors make it more likely for a woman with high-risk HPV infection of the cervix to develop cervical cancer. A weakened immune system lowers the body’s ability to fight an HPV infection. Women that smoke or are exposed to secondhand smoke have an increased risk of developing cervical cancer. Also, the use of birth control pills and giving birth to many children increase the risk of cervical cancer. Obese women have a higher chance of concealing cervical cancer in their bodies because of the difficulty associated with pre-cancer screening.
Ignorance, self-medication, fear of stigmatisation and lack of screening and treatment centres are part of the reasons cervical cancer incidents have continued to increase. Many African women do not know that cervical cancer is preventable and highly curable if detected early. Research shows that nearly all cervical cancers could be prevented by HPV vaccination, routine cervical cancer screening, and appropriate follow-up treatment as the need arises. The most protection is administering a HPV vaccine before a person becomes sexually active. A routine HPV vaccination for girls and boys at age 11 or 12 is highly recommended till 26. Unvaccinated adults between the ages of 27 and 45 may choose to get the HPV vaccine. Due to the casualty rate associated with cervical cancer, sexually active youths are advised to use condoms to decrease the risk of HPV transmission.
We lament the poor access to HPV vaccination and cervical cancer screening across Africa, with only 29 out of 47 countries in the African Region introducing the HPV vaccine into their national immunisation programmes. Unfortunately, only 40 per cent of eligible girls had received at least one dose. There is the need to meet the 2030 target set by WHO in its 2020 Global Strategy to Accelerate the Elimination of Cervical Cancer, which made WHO to update its recommendations to support a single-dose HPV vaccine and reduce logistical barriers.
It is encouraging that major funding initiatives are underway to support the fight against cervical cancer in Africa. The expected fund should be adequately utilised. Good enough, the World Bank, in collaboration with the Global Financing Facility (GFF), has pledged $400 million over the next three years for HPV-related programming. Also, Gavi, the Vaccine Alliance, has pledged to immunise 86 million girls in low-and middle-income countries by 2025. Without doubt, the intervention will avert over 1.4 million deaths. Though HPV vaccination doesn’t protect against all HPV types that can cause cervical cancer, getting screened at regular intervals is recommended in Africa. At the same time, early detection saves lives.