• Experts give tips on how to prevent, manage spreading scourge
By Ngozi Nwoke
Cervical cancer remains a significant health challenge for women in Nigeria, claiming thousands of lives every year. Despite being curable and preventable, the disease continues to spread, with many women lacking access to effective screening and treatment.
Statistics show that the scourge is one of the leading causes of cancer death among women in Nigeria. It is often caused by the human papillomavirus (HPV), which can be transmitted through unprotected sex. Experts believe that vaccinating young girls against HPV can significantly reduce the risk of cervical cancer.
They are urging the government, NGOs, and other stakeholders to take immediate action to address the crisis. This includes increasing funding for HPV vaccinations, improving access to screening and treatment, and raising awareness about the disease.
There are fears that if left unchecked, cervical cancer could continue to claim more lives and impose a significant economic burden on victims and their families. It is estimated that Nigeria needs a substantial investment to eliminate cervical cancer by 2030.
To combat the spread, they recommend a multi-faceted approach that includes HPV vaccination, regular screening, and effective treatment. By working together, Nigeria can reduce the prevalence of cervical cancer and save thousands of lives.
Cervical cancer, a preventable disease, has become the second most common cancer affecting women in Nigeria, according to David Odunsi, a Lagos-based health professional.
He noted: “Cervical cancer, despite being preventable, is the second most common cancer affecting women in Nigeria. The incidence rate varies across states in Nigeria largely influenced by factors like availability of screening, diagnosis, early presentation at the hospital, data entry into the cancer registry which seems to be at different levels of efficiency across the various states of the federation.”
Odunsi noted that “available data from the International Agency for Research on Cancer, a specialised agency of the World Health Organisation, put the incidence rate of cervical cancer in Nigeria at 26.2 per 100,000 women, with 13,676 new cases and 7,093 deaths in 2022.”
He attributed the high incidence rate to limited public health education, poverty, misconceptions, cultural beliefs, and limited healthcare access.
“Only about one-tenth to two-tenths of women eligible for cervical cancer screening get screened,” Odunsi lamented.
He further explained that “factors that have been identified include low public health education, poverty, misconceptions and cultural beliefs, limited healthcare access, and limited availability of screening programmes.”
Odunsi also highlighted the challenges patients face after diagnosis, saying “the most worrisome aspect of all of these is that the problem doesn’t end after a diagnosis is made, rather it signals the start of a tortuous journey of navigating through high cost of treatment, psycho-social issues like depression, anxiety, stigmatisation as well as economic burden on the family members.”
He added that “the back and forth of treatment means patients may have to be out of the job as well, thereby affecting their means of livelihood.”
The healthcare system in Nigeria also exacerbates the problem, with inadequate trained personnel, specialised cancer centres, radiotherapy and chemotherapy facilities.
Odunsi noted that “our healthcare system also adds to their problems with a shortage of trained personnel or overstretched ones to take care of them, coupled with inadequate specialised cancer centres equipped with radiotherapy and chemotherapy facilities.”
The medical doctor called for increased efforts to combat cervical cancer, emphasising the need for screening, vaccination, and early detection. He also lamented the lack of political will to support cancer treatment in Nigeria, stating that not until recently, there has been little or no political will to support cancer treatment in the country.
Ekpenyong Gilbert, a Lagos-based medical doctor, accessing cervical cancer treatment in Nigeria highlights significant challenges faced mostly by women who suffer from the disease in both urban and rural areas.
He said: “These challenges include insufficient treatment sites and lack of access to facilities, particularly in rural areas, shortage of trained personnel, including cytopathologists, to provide cervical cancer screening and treatment services.”
He added that low public awareness about cervical cancer, its causes, and the importance of screening leads to low demand for services.
He also highlighted the role of socio-cultural factors, including stigma and misconceptions that hinder cervical cancer screening and treatment as major concerns.
To promote cervical cancer prevention and control in Nigeria, Gilbert emphasised the need for a multi-faceted approach.
He stated: “To promote cervical cancer prevention and control in Nigeria, governments, NGOs, and public health workers can play by allocating more resources to cervical cancer prevention and control programmes.”
Some potential solutions include developing and equipping healthcare facilities, especially in rural areas, and incorporating cervical cancer screening and treatment into existing healthcare programmes such as HIV clinics.
He also suggested organising public awareness campaigns to educate people about cervical cancer and the importance of screening.
“Other potential solutions include offering financial assistance to individuals and communities to access cervical cancer services, advocating for policies that support cervical cancer prevention and control, providing education on cervical cancer, its causes, and the importance of screening, and encouraging women to undergo cervical cancer screening.
Gilbert’s recommendations offer a roadmap for addressing the challenges of cervical cancer in Nigeria. By working together, the burden of cervical cancer can reduce, and healthcare can improve the outcomes of women across the country.
Mercy Korir, a public health specialist, who shared her thoughts, noted that cervical cancer is a preventable and curable disease that requires urgent attention.
She urged that it was time for Nigeria to take action and prioritise the health and well-being of its women.
She stressed that by investing in HPV vaccination, screening, and treatment, the country can make significant progress in reducing the burden of cervical cancer.
The medical expert emphasised the importance of HPV vaccination and regular cervical cancer screenings for women’s health.
According to her, these measures are crucial in preventing and detecting cervical cancer.
She noted: “The HPV vaccine protects against high-risk human papillomavirus types that cause most cervical cancers. By preventing HPV infection, the vaccine significantly reduces the risk of developing cervical cancer.
“The vaccine also protects against other HPV-related diseases, such as genital warts and some cancers of the vulva, vagina, and oropharynx.”
Korir further highlighted the importance of regular cervical cancer screenings, which can detect abnormal cell changes in the cervix before they become cancerous.
“Screening can identify precancerous lesions, which can be treated to prevent cervical cancer. If cervical cancer is detected early, treatment is more effective, and the chances of survival are higher. Regular screenings can reduce cervical cancer mortality rates by detecting the disease at an early stage,” she disclosed.
According to Korir, combining HPV vaccination and screenings provides comprehensive protection against cervical cancer. “Vaccination and screenings can provide long-term benefits, reducing the risk of cervical cancer and related diseases,” she emphasised.
The medical expert urged women to follow the recommended vaccination and screening schedules to protect their health.
“The HPV vaccine and regular cervical cancer screenings are crucial for preventing and detecting cervical cancer. I strongly recommend women follow the recommended vaccination and screening schedules to protect their health,” Korir concluded.
To corroborate Korir’s submission, Kgosi Letlape, a South African-based oncologist was alarmed that approximately 17,000 new cases of cervical cancer are diagnosed every year in Nigeria. He stressed that the situation is further compounded by the high mortality rate, with around 7,368 women dying from cervical cancer annually.
This translates to 22 deaths recorded daily, a stark reality that underscores the gravity of the situation. Public health authorities estimate that about 60 million women in Nigeria are at risk of developing cervical cancer, particularly those living with HIV who face a six-fold increased risk.
Letlape lamented that 80 per cent of women with cervical cancer present their cases late, at the level when treatment and complete recovery are no longer possible.
He added that many women lack access to cervical cancer screening and treatment services, contributing to high mortality rates.
He highlighted: “Ignorance and late presentation are significant factors contributing to the high incidence and mortality rates of cervical cancer in Nigeria. Sub-optimal treatment infrastructure also hinders effective management of cervical cancer cases.”
To combat this menace, Letlape emphasised the need for efforts to raise awareness about cervical cancer and promote screening and early detection.
“Efforts to raise awareness about cervical cancer and promote screening and early detection are crucial to reducing the burden of the disease,” he said.
As the nation grapples with this growing health concern, it is imperative that stakeholders take immediate action to address the challenges and improve the healthcare system. The lives of thousands of Nigerian women depend on it.
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