In 2023, no woman should die of cervical cancer

In 2023, cervical cancer should not be killing any woman. Yet, an estimated 342,000 deaths occurred from cervical cancer in 2020, with about 90 per cent of these occurring in low- and middle-income countries. According to World Health Organisation reports, limited access to preventative measures and late diagnosis are the main contributing factors to cervical cancer fatalities. In addition, treatment (cancer surgery, radiotherapy and chemotherapy) may be limited, resulting in a higher rate of deaths in developing countries.

As a reproduction expert, I have encountered a number of women who come to the clinic exhibiting advanced symptoms of cervical cancer, yet they are unaware of it.

I remember Tabitha’s case. She came to the clinic complaining of a persistent smelly vaginal discharge.

“I am unable to have sex these days because the smell turns my husband off,” she lamented, “I have seen many doctors for the last months, who have put me on antibiotics with no improvement.”

Then there was Charity. In her case, there was bleeding after sex. “I have no pain and so I have had no reason to seek treatment but now my husband is upset because every time we make love, everything is bloody,” she explained.

Tabitha and Charity’s symptoms represent advanced stages of cervical cancer. In almost all cases, women with the disease have no symptoms. It is for this reason that the cancer continues to ravage lives. In Kenya 4800 new cases are diagnosed each year and 2450 deaths happen translating to about seven deaths each day. The cancer is only second to breast cancer among cancers affecting women in Kenya.

“What annoys me is that this is a totally preventable condition; whenever our women die of diseases we can prevent, I see it as a total injustice that should not be tolerated in the 21^st century,” Gladys, a women’s rights activist once told me. She had come to the clinic to find out the cost of a pap smear, a test that is done to detect cancerous changes in the cervix. Many women are unable to access the test because it is not available in many hospitals and where it is offered, it is unfordable to many.

Interestingly, cervical cancer is not found in celibate women. This made scientists study the link between having sex and developing the cancer. Some of the risk factors associated with the disease were found to be early sexual debut, especially if the sex is unprotected. Similarly, the number of sex partners was a factor, with the risk rising with the number of partners.  

The link identified between having sex and developing the cancer is the Human Papilloma Virus (HPV). This virus is transmitted sexually. The bad news is that 50 percent of the population is infected with HPV and unfortunately, they are not aware of the infection since it carries no symptoms. This translates to a 50 perfect chance of getting infected whenever one has unprotected sex. Among all women having the cancer, up to 98 percent have an HPV infection in their cervix.

In most cases, if you get infected with HPV your immune system easily clears it from the body. In other cases, however, the virus persists in the cervix and over time causes abnormality in the cells turning them cancerous. This can take many years, as long as 10 to 20 years so those exposed to the virus in their teenage will likely develop the disease after the age of 30.

The virus persists when the immune system is weak. Pregnancy, smoking, malnutrition, HIV and other chronic illnesses weaken the immune system thereby increasing the risk of HPV persisting and causing cells to become cancerous.

In case you are already infected by this virus, the good news is that it can easily be detected through laboratory tests. Of course, tests for identifying the virus can be expensive. Further, not every woman with an infection develops the cancer. It is therefore better to have a screening test such as a pap smear. If you are sexually active and below the age of 30, do the screening at least once every three years to check on the status of the cells of your cervix. Those above 30 should do both pap smears and tests to detect HPV infection. These tests help identify women who would be developing cancer in years to come. Treating HPV infection as well as abnormal cells in the cervix is easy and effective in preventing cancer from developing and has helped to nearly eradicate the cancer in developed countries.

“No woman should ever die of cervical cancer, a disease that’s almost 100 percent preventable. We know what causes it, we know how to prevent it, and it’s time to end it,” says Anne Marie Murphy, PhD, of the Equal Hope organisation.

It is sad and unfortunate that women continue to die from this preventable disease. We can commit as a country to stop it. We have the knowledge of what is needed, all we need is to put the needed resources in place and we will be able to save the seven lives we lose each day.