Cervical Cancer- No 2 killer among women-Lekma Hospital
It has emerged that cervical cancer since last year has been the second most killer among women in Ghana, second only to breast cancer.
In some communities, like the Ledzokuku/Krowor municipality of the Greater Accra Region, the disease is the foremost killer of women, according to Doctor Ruth Dayo Ukwelenwa of the LEKMA Hospital at Teshie.
Explaining the phenomenon, Dr Dayo said research by the Ghana teaching hospitals especially the gynecology units, has shown that cervical cancer is the leading cause of deaths among women referred from smaller hospitals.
The lack of awareness of the sickness, according to her, remains a high contributing factor for the increasing deaths.
“In this part of our world, many are still not aware that there is screening and vaccination. The rate of awareness to these killer cancers in Africa is mostly on the low”, she said.
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A further enquiry from the Ghana Health Service Programme Manager for Non-Communicable Diseases, Dr Dennis Laryea said statistical records in 2018 confirms a total of 13807, 3151 representing 22.8% women with new cancer cases.
According to the deputy programme manager for Non-communicable Disease Dr. Efua Commeh, Cervical cancer and breast cancer keeps competing with each other every year as either the first or second leading cause of death among women.”
She said this year, an average of about 3,100 cervical cancer cases has been recorded making it the second leading cancer cause of death among women, of which breast cancer leads with about 4,600 death cases, making it the number one cause of death among women in the country.
The Human Papillomavirus (HPV) is the most common sexually transmitted infection. This infection is so widespread that millions of Africans have this infection.
Over 35 out of the 100 types of this infection can get into a woman’s vagina, cervix, the anus, a man’s penis, and scrotum, the mouth and throat.
Since this virus is sexually transmitted, by skin to skin contact, people who are sexually active stand a high risk of getting this infection.
Dr Dayo lamented that many waits till they see symptoms of this disease before visiting hospital, especially when the condition is on a high stage, “usually there is nothing much a doctor can do to save such people than giving them medications to lower the pain if the cancer is at its final stage.” She said.
How HPV Is Spread
The difference between HIV and HPV is that the risk of HIV is strongly associated with two things: vaginal sex and anal sex.
By contrast, HPV is spread through the intimate skin-to-skin contact, including mutual masturbation (an activity that carries a negligible risk of HIV)
She added that patients or women who are immune suppressed with conditions like HIV/AIDS, or women on medications that suppresses the immune system especially for those who are going for organ transplantation and those on steroids stands a risk of developing this type of cancer.
Speaking to a Nigerian Doctor Dr Eton Ogechukwu through my research has shown that
Cervical cancer is not just killing Ghanaian women but Nigerians as well.
“One of the causes of death among women in Nigeria is as a result of cervical cancer”.
Dr Dayo said, cervical cancer has different types which are the type 6, 11, 16, 18, 31 and 33. The type 6 and 11 she said, causes mild pains (early stages) the other types which are type 16, 18, 31 and 33, are associated with cancer cells that can develop into sever cervical cancer.
“For majority of people, after a period of time the cancer resolve while with others the infection gets progressed and develops into cancer.”
This means it takes a while for the infection to transform into cervical cancer.
Who is at risk?
She stated that the early stages of Cervical Cancer may be completely symptom free; however every woman that is sexually active is at a high risk of being affected even if the woman is married.
“Women who have more than one sexual partner or husbands having other sexual partner’s aside their wives, stands a higher risk transferring it from other women to their wives.” She stressed that with this infection, men and women gets it alike.
Young sexually active girls
She furthered that young girls who started having sex or got introduced to sex at an early age also stands a higher chance of getting affected with cervical cancer.
The Dr explained that women who smoke are the number one people who can contract this type of cancer aside sexual means.
“The exact relation between smoking and cervical cancer she said is not clear, but it’s been found out that women that smokes, stands a high risk of developing this type of cancer.”
She added that Lesbians are known to have the lowest risk of getting HIV in large part to the types of sexual activities (including oral sex) less commonly associated with infection.
Some have taken this to mean that lesbians are, in general, less susceptible to other types of sexually transmitted infections such as human papillomavirus (HPV), the virus linked to the development of cervical cancer.
Speaking to a Nigerian Doctor Dr Eton Ogechukwu through my research has also shown that
Cervical cancer is not just killing Ghanaian women but Nigerians as well.
“One of the causes of death among women in Nigeria is as a result of cervical cancer”. She said.
Suggestive Cervical Cancer includes;
Irregular menses, bleeding in-between one's menstrual periods, Menorrhagia: Heavy menstrual bleeding, Post- coital bleeding: Bleeding after sexual intercourse, Post- menopausal bleeding: Bleeding after menopause, Dyspareunia- Pain during sexual intercourse, Unexplained, persistent pelvic/ back pain, Unusual vaginal discharge ( foul smelling, pink, brownish or bloody discharge), Persistent feeling of nausea/ indigestion or unexplainable weight loss.
She added that long term use of oral contraceptives ( above 5years) she said can be a factor, Multiple pregnancies ( 3 or more full term pregnancy), Family history of Cervical Cancer, Early coitus (First full term pregnancy below the age of 17years.
All these she said can predispose one to having Cervical Cancer.
Age of contraction
The age range of people who gets this infection is a pick of women from the ages of 30 to 50 years.
But with younger people is not a never to contract this virus because it takes a while for this symptoms to show, therefore if a 15 year old girl is affected, the symptoms may start showing in their 30s to 50s.
Cervical cancer takes about 10 to 30 years before it becomes developed.
Statistics of past years
Cervical cancer is the third most commonly diagnosed cancer worldwide and the fourth leading cause of cancer deaths among women globally.
The disease is estimated to cause about 266,000 deaths annually worldwide.
Every year, 3,000 women were diagnosed with cervical cancer in Ghana representing 35 per cent of all female cancers.
Over the past decades, the incidence of cervical cancer has however reduced by a third and mortality by half. It has been shown that the cervical screening programme is associated with the improvement in cervical cancer treatment rates.
In Ghana, it is estimated that about 3,052 new cervical cancer cases were recorded in 2012, representing 32.7 per cent of the total cancer cases among women in the country. Cervical cancer is believed to be highly preventable with the use of cervical cancer screening tools.
In the early stage, cervical cancer can easily be treated. In its advanced stage, the treatment of the disease could be very challenging or impossible.
Owing to low awareness of cervical cancer in Ghana, over 90 per cent of the cases presented in health facilities tend to be at the advanced stage where the disease has already spread. Consequently, cervical cancer incidence and mortality rates in Ghana become one of the highest in the world.
Cervical Cancer is the third most common malignancy amongst women worldwide and it remains the leading cause of cancer death for women in developing countries including Ghana.
Globally an estimated 528,000 new cases were seen and 266,000 deaths occurred in 2012.
A study done in 2012 in Ghana gave an estimate of 3,052 new cases and 1, 556 deaths.
WHO also estimated additional cases of Cervical Cancer to be over 5,000 in Ghana with at least 3,300 deaths in 2025.
The good news here is that, it’s been found out that virgins and the nuns whose sexuality is low are not likely to come down with this infection.
Screening and Vaccination
According to Dr. Commeh, the cost of screening has been reduced to enable every woman gain access.
Education and creating awareness of early detection is key in preventing the spread of the HPV infection from one person to another. Abstinence and the screening of the affected partner should be emphasized.
Cost of screening
The Pap smear she said, ranges from GH 75.00 to GH 150.00 in Ridge Hospital and could be available in Pharmacies.
Pap smears look for small cellular changes in the cervix, and require a trained pathologis.
Pap smears are considered the gold standard of cervical screening. Unfortunately, they require skilled practitioners and good laboratories to be effective.
The second type is the Visual Inspection with Acetic Acid (VIA) GH 25.00 of which many can afford. This device is only available in the hospitals.
HPV tests are good at identifying women at risk for cancer. However, they do not actually diagnose cancer and come at a non-trivial expense.
That is why doctors have developed a test known as visual inspection with acetic acid (VIA). It is cheap, easy, and effective.
Currently there are two HPV vaccines available worldwide Gardasil ( HPV 16,18,6,11) and Cevarix(HPV 16,18) These vaccines when administered before exposure significantly reduce the risk of both cancer and precancerous changes in the cervix and perineum by 93% and 62% respectively.
What Is VIA?
Visual Inspection with Acetic Acid, or VIA, sounds like a scary way to test for cervical cancer. In reality, it's quite simple.
VIA allows doctors to directly see lesions and other changes in the cervix that are large enough to, presumably, need treatment.
The VIA procedure is quite straightforward. The healthcare provider simply swabs vinegar, i.e. acetic acid, on the cervix. Then they look for areas that change color.
The actual screening involves the early detection and removal of abnormal tissue or cell in the cervix. The screening methods include: Pap smear, liquid based cytology and HPV testing.
The use of barrier protection methods like condoms and spermicidal gel during intercourse decreases the risk of Cervical Cancer.
Dr Ruth said that women who are sexually active must go for screening as soon as possible. “Women must make it a point to be screened every three years”
She also said young girls who are not yet sexually active should also be vaccinated against the virus before they get sexually active.
Dr Ruth further appeals to the public, husbands and relatives to protect our women and our girls by encouraging them to go for screening.
Because the more we overlook this cancer issues, the more we lose mothers of nation builders.