Cervical cancer in women in developing countries/Cancer cerebral chez les Femmes dans les pays en developpement.

• Author: Mafubelu, Daisy

Cervical cancer is the number one killer cancer of women in developing countries and is caused by the Human Papillomavirus (HPV). Cervical cancer is the cause of about 270 000 deaths that occur every year. Out of these deaths and the 500 000 new cases diagnosed globally, 80% are in developing countries with sub Saharan Africa being the most affected. HIV positive women are four times at risk of getting infected with cervical cancer.

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Nevertheless, cervical cancer is a potentially preventable disease especially with the introduction of vaccines against HPV. There is primary prevention which is before infection with HPV and involves the delay of sexual activity and vaccination. The second type of prevention is the secondary prevention especially after sexual debut. It requires one to go for regular cervical screening which include; pap smears, direct visualization and rapid testing. One is also advised to limit the number of sexual partners. A vaccine against HPV that protects against infection and disease associated with HIV is now available while another is in the advanced clinical testing. The HPV vaccination has the potential to build synergy among immunisation, cancer control and sexual and reproductive health programmes. Vaccination before exposure is more effective and has the greatest impact and therefore the need to target preadolescent girls aged 9-12. However, the safety and efficacy of the vaccines have not yet been evaluated in Africa and in populations with a high prevalence to HIV infection. The duration of protection is also not yet known but can last for at least five years.

The availability of the vaccines is being deterred by several factors the major one being the cost of such process as; screening, follow ups and treatment which are inaccessible to many women in Africa. Public health priority, based on factors such as burden of the disease, effectiveness and safety of vaccines, availability of other interventions and programme strength and ability to deliver are among the decisions that will determine the introduction of the vaccine. In order to win the battle on cervical cancer certain choices have to be made and that includes prioritising on girls and young women including boys and young men, determining where to start, and finding innovative ways to finance the vaccine introduction. Other ways are; managing misconceptions and expectations in Linking with sexual and reproductive health services and...