According to the Cancer Association of South Africa, one in eight South African women will develop cancer over the course of her lifetime, with cervical cancer being the second most common in this population group and the National Cancer Registry estimating a lifetime risk of one in 39 women developing the disease. Additionally, a paper published last year in The Lancet revealed that nine out of 10 cervical cancer deaths worldwide occur in low- and middle-income countries such as our own. Because most women do not have symptoms in the early stages of cervical cancer, regular screening is essential and although the statistics may be alarming, there’s also good news coming from the research front of the fight against the disease, particularly in terms of prevention.
Screening
Almost all cervical cancer is caused by the human papilloma virus (HPV), with around 70 percent of cases, says CANSA, caused by high-risk HPV types 16 and 18. Unlike the lower risk types, which can cause visible genital warts, high-risk HPV may be asymptomatic, meaning many women only learn that they are infected when they have an irregular Pap smear – also how most early cases of cervical cancer are discovered. As such, CANSA advocates that all women who have ever been sexually active should start going for three-yearly Pap smears between the ages of 18 and 20 years, or one or two years after first having sexual intercourse, should that occur after age 20.
Prevention
The biggest breakthrough in recent years against cervical cancer has been the development of the HPV vaccine. CANSA’s official position is one in favour of vaccinating all prepubescent girls with the vaccine protecting specifically against the most common high-risk strains. The Department of Health recently implemented an HPV vaccination programme in all public schools with the second round currently being rolled out. This gives all grade four learners the opportunity to receive the vaccine, available in two doses, free of charge – hopefully before any exposure to the virus. However, CANSA advocates that all women who are not yet sexually active (up to the age of 26) get the vaccine, as statistics show that almost seven in 10 people will be infected with a strain of HPV at some point in their lifetime. Its importance can’t be stressed enough: an article published by the American Society of Clinical Oncology indicated that the vaccine could prevent up to 90 percent of HPV-related cancers worldwide – that’s a big deal!
Preventable risk factors that may increase your risk of developing cervical cancer include:
- Multiple sexual partners
- High-risk sexual activity and failure to use protective barrier methods
- Ineffective treatment of sexually transmitted infections
- Smoking
- Having sex at an early age
When to see your doctor
While they may well indicate something far more benign, never ignore the following symptoms:
- Abnormal vaginal bleeding after sex or between periods
- Any vaginal bleeding after menopause
- Unusual or persistent vaginal discharge
- Pelvic pain or pain during sex
- Periods that become longer and heavier
Early detection is key
More than 95 percent of women who are diagnosed in the early stages of the disease are still alive five years after diagnosis.