Cervical Cancer

CERVICAL CANCER PREVENTION

WHAT IS CERVICAL CANCER?

Cervical cancer is a type of cancer that occurs in the cells of the opening of the womb known as the cervix.

What causes cervical cancer?

It is caused by a persistent infection with one or more of the high-risk types of Human Papiloma Virus (HPV 16 and 18)

Some Key Facts about Cervical Cancer

  • 4out of 5 people will have atleast one type of HPV infection during their life time
  • Most HPV do not cause symptoms so many people do not know they are infected.
  • HPV is sexually transmitted viral infection among men and women
  • It manifest in women
  • It is preventable
  • In its early stages it has no signs and symptoms
  • Early detection and timely treatment saves lives

How can we prevent cervical cancer?

According to WHO comprehensive approach

Primary prevention: girls 9-13

  • HPV vaccination: girls and boys as appropriate
  • Health information and warnings about tobacco use
  • Sexuality education tailored to age and culture
  • Male circumcision

Secondary prevention: above 30 years

  • “screen and treat” with low cost technology
  • HPV testing for high risk HPV types (16,18)
  • Papanicoulao test (PAP test)

Tertiary prevention: all women as needed

  • Treatment for invasive cancer at any age
  • Ablative surgery
  • Radiotherapy
  • Chemotherapy
  • Thermal coagulation (TC)-thermal ablation ( heat or burning): Tools used are the box containing a 16mm flate probe, 19mm flat probe, 19mm flat nipple, the hand unit, the batteries(2) the devise is used at 100oc
  • Cryotherapy (cold or freezing) the probe is cold using CO2 on nitrous oxide. Or excition (surgical removal of the abnormal area) called conization or LEEP ( loop electrosurgical excision procedure for high grade lesions

The choice of procedure is determined by a qualified health care professional, and can greatly reduce the risk of developing invasive cancer.

The definitive diagnosis of invasive cancer cervical cancer is made through a coposcopy/biopsy. Women diagnosed with early invasive cervical cancer can be cured with effective treatment. If left untreated, invasive cervical cancer is almost fatal. Treatment options for invasive cervical cancer include: surgery, radiotherapy and chemotherapy. These may be used in combination

Risks factors for cervical cancer

  • Co-infection with other sexually transmitted infections
  • Immuno-supression due to HIV/AIDS infections
  • Tobacco use
  • Having sex with multiple partners
  • Start sexual activity early in life
Cervical Cancer

Who should be screened for cervical cancer?

Any women who is sexually active! Target population for screening is women aged 25 to 49 years, although women aged 50-65 years are still at risk of cervical cancer and there should therefore receive screening. Screening interval is 5years among women tested negative for HIV and every year for women who are HIV positive.

How is the screening procedure?

  1. VIA – Visual Inspection with Acetic acid (or vinegar at 5%)
  2. VILI- Visual Inspection with Logul’s Iodine (done after VIA)
  3. Papnicouloa Test (Pap smear) where cell samples are collected from the cervix and smeared on the slide and preserved with a solution then labeled for observation under the microscope by a cytologist
  4. HPV DNA test: where samples are collected to examine for high risks HPV (16 and 18)

VIA and VILI results are read on the spot as negative, positive for pre-cancer or suspicious for cancer

PAP Test and HPV Test take a while like one week to get the results read as negative, positive for high grade lesion and suspicious for cancer.

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