Cervical Cancer Crisis: Nigeria, 4 Others In The Eye Of The Storm

HALF of all women who die of  cervical cancer live in just five countries – India, China, Brazil, Bangladesh and Nigeria, even as Africa has been identified as the most dangerous place to be a woman with cervical cancer.

A new Cervical Cancer Crisis Card launched globally  by the Cervical Cancer Free Coalition, in commemoration of  International Mother’s Day on Sunday 12 May, put the annual total death count from the five top-ranked countries  at 137,817, compared to an estimated 275,000 annual total deaths from 500,000 new cases recorded in the 50 countries  surveyed.

The Crisis Card ranks countries from across the world based on the number of deaths from cervical cancer and the mortality rate from the disease. Nigeria and 49 other  countries were selected to provide a snapshot of the world and reflect geographic, economic and population variations.

Using data from the World Health Organisation, WHO, United Nations, the World Bank and IARC Globocan, the Crisis Cards (mortality rate and death count) highlight the inequity women face depending on where they live.

From the data, more women die of cervical cancer in India (comparatively ranked  No.1)  than anywhere else on Earth, while Norway (ranked 50) records the least number of deaths. A total of 9,659 deaths are recorded in Nigeria (ranked 5)every year.

Zambia with 38.6 deaths per 100,000, has the highest cervical cancer mortality rate in the world while Australia (1.4 deaths per 100,000) has the lowest. Nigeria, ranked 10th, has a cervical cancer mortality rate of 22.9 deaths per 100,000. Worse still, the crisis card showed that the top 10 countries with the highest cervical cancer mortality rates can be found in Africa. For instance, Sub-Saharan Africa has 22 percent of all cervical cancer cases worldwide.

Australia’s successful control of the disorder is attributed to “the successful rollout of a comprehensive package of HPV vaccines, treatment and prevention.”

Recognising cervical cancer as “an entirely preventable disease and the second largest cancer killer of women in low and middle-income countries, where most women are dying in the prime of life”, the Crisis Card quoted projections showing that by 2030, almost half a million women will die of cervical cancer, with over 98 percent of these deaths expected to occur in the low and middle- income countries.

In a reaction, Vice-Chancellor, University of Ibadan, Professor Isaac Adewole, remarked: “Twenty-six Nigerian women lose their lives due to cervical cancer every day and a further 14,000 women are diagnosed each year with this disease. Cervical cancer can be almost entirely prevented through the use of vaccines that are being used around the world.

“Early screening methods and prompt treatment are also critical interventions that can save women’s lives.  What is required of us all, is a renewed commitment to saving the lives of our women and preventing a preventable death,” Adewole noted.

Also reacting, the Director of Hospital Services, Federal Minstry of Health of Nigeria, FMOH, Dr. Patience Osinubi, confirmed the dismal statistics.  “The data of 14,000 annual incidence is correct. I am not sure of the other data. The high incidence can be brought down primarily through HPV vaccination for those not  sexually exposed and those who test negative for HPV DNA.

“Others can prevent it through regular annual PAP smear screening or Visual Inspection through Acetic acid, VIA, testing. The key fact is that early detection of any cancer saves lives.”

Dr Jennifer Smith, Executive Director of the Cervical Cancer Free Coalition said: “Cervical cancer is a preventable cancer, yet we are still seeing so many deaths around the world. At Cervical Cancer Free Coalition we are working towards building networks across the globe to help support our common goal of a world free of cervical cancer. Together we can dramatically reduce this disease through vaccination, screening and education.”

Seth Berkley, CEO of the GAVI Alliance described 2013 as the beginning of a dramatic shift in women’s health. “A new low price for the HPV vaccine has been negotiated by GAVI for countries eligible for support, opening the door for millions of girls in the world’s poorest countries to be protected against one of the leading cancer killers of women.”

Coming in the same month as the global Women Deliver 2013 conference that will have a focus on gender and health equity in terms of the post-2015 framework (follow framework to the Millennium Development Goals, the Report is a timely reminder of the challenges facing women, especially in the low to middle income countries. By prioritising women’s health in the next developmental framework, world leaders would show that they’re serious about challenging inequity and building sustainable societies where universal rights are guaranteed for all.

Dr Rosa, Professor of Oncological Gynecology at the University of Lagos Teaching Hospital, LUTH, said,“Knowledge and awareness of cervical cancer, a preventable disease, is very low, while the toll of cervical cancer on Nigerian women is very high. Indeed, cervical cancer in Nigeria and in sub-Saharan as a whole must be given the same priority as HIV, malaria, tuberculosis and childhood immunisations. Governments in this region must wake up to this call.”

Urging prompt action, the  crisis card calls for women to be encouraged to visit their health provider for early screening of precancers using either the pap smear (colposcopy), visual inspection with acetic acid (VIA) and HPV testing to help diagnose precancerous cells.

It also urges the national rollout of a comprehensive approach to cervical cancer that includes the scaling up of screening and treatment options and vaccines that prevent infection with high-risk HPV strands linked to cervical cancer, treatment of precancers is advancing, which provides hope to the hundreds of thousands of women who missed out on the vaccine. Health systems need to be strengthened so that all women who need access to treatment can access affordable, quality care.

Credits to Sola Ogundipe

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