Importance of cervical cancer screening

Article: Salome Donkor
The cervix of women which can be found in the lower part of the uterus (womb) that opens into the vagina, performs three main significant functions. It is necessary for conception, serves as a gatekeeper and produces mucus which serves as lubricant that provides a physical barrier and prevents infections in women.
Despite these important roles of the cervix, there are times when abnormal cervical cell changes may occur, rarely presenting symptoms. The symptoms become visible if those cells develop into cervical cancer.
The disease develops as a result of persistent infection into a cancer-causing virus, known as human papilloma virus (HPV). The virus is extremely common and easily transmitted from skin-to-skin contact in the genital area.
Addressing a training seminar for a group of journalists in Accra, Dr Linda Decker of Franklyn Medical Services, said although there are about 100 types of HPV, not all of them cause cervical cancer, adding that some of them cause genital warts, but other types may not present any symptoms.
She explained that 15 out of the 100 types of the HPV can cause cancer and out of this, only two have a high association with cervical cancer.
She said symptoms of cervical cancer may include bleeding from the vagina that is not normal or a change in menstrual cycle that cannot be explained, bleeding when something comes in contact with one’s cervix, such as during sex, pain during sex and vaginal discharge that is tinged with blood.
Medical experts say globally, cervical cancer is the second most common cancer affecting women under age 45 and it is the third leading cause of cancer death among women globally, after breast and lung cancers.
Approximately 270,000 deaths per year result from cervical cancer worldwide, and in Sub-Saharan Africa, cervical cancer is the dominant cancer and leading cause of cancer mortality in the region, causing slow and painful death among patients due to late diagnosis and lack of access to cancer treatment.
In Ghana, cervical cancer is one of the most frequent cancer types that affect women and the leading cause of cancer mortality. It is estimated that each year approximately 2,000 women will develop cervical cancer and 80 per cent will die from the disease.
Looking at the above statistics not merely as numbers but relating them to the suffering encountered by someone’s wife, mother, sister, daughter or friend helps to put the issue in a better perspective.
As a result of a public service initiative to equip journalists and make them ambassadors in the fight for women against cervical cancer, the Pharmaceutical Society of Ghana (PSG), in collaboration with GlaxoSmithKline Ghana, organised the training programme for media practitioners drawn from both the electronic and print media in Accra.
Elaborating on women who were at risk of contracting the disease, she said sexually active women were at risk and that the risk began with a sexual debut, worsening with the early onset of sex and lasted throughout a woman’s lifetime.
She explained that using condoms did not offer full protection against HPV because penetrative intercourse was not the only means of transmitting HPV.
She indicated that the number of lifetime sex partners, age at sexual debut and current smokers were the risk factors.
Dr Decker said screening was important and should be done once a year but that was inadequate, hence the need to look at vaccination to eliminate the primary causes of the disease.
She also said because the spread of the disease is largely related to the relationship between sexual activity, abstinence is the best preventive measure.
Dr Decker asserted that in developing countries where adequate screening programmes were lacking, there was the need to work out sustainable screening programmes, adding that the disease was a major health burden for women in developing countries.
She said as part of a regular pelvic examination, every woman should have a Pap test during which the doctor scrapes a small sample of cells from the surface of the cervix to examine for cell changes.
She said if the Pap test showed abnormal cell changes, the doctor may do other tests to look for pre-cancerous or cancer cells and indicated that it was important to follow up to see the doctor after any abnormal Pap test result to treat abnormal cell changes and that may help prevent cervical cancer.
According to Dr Decker, in Ghana, screening is done at the major hospitals, namely, Korle Bu and Komfo Anokye Teaching hospitals in Accra and Kumasi, respectively, as well as the Tema General Hospital and the Ridge Hospital in Accra.
Mr Emmanuel Acquah of GlaxoSmithKline Ghana said the disease developed at various stages and depending on the stage of its development, it was either reversible or irreversible.
He said like other diseases, early diagnosis and treatment was the best answer.