Libertine N.K.M Hauwanga
Cervical cancer is pervasive in women globally, with more than 570 000 new cases and 311 000 mortalities reported (WHO, 2018). Of the aforementioned deaths, 85% occur in low and middle- income countries and Namibia is no exception. The human papillomavirus (HPV) causes closely (over 99%) of cervical cancers.
Present estimates depict that 236 women are diagnosed with cervical cancer annually and 135 die from the disease in Namibia as it ranks the second common cancer after breast cancer. Most of these women are in the prime of their lives. Women living with HIV are six times more likely to get cervical cancer compared to HIV negative women.
Comprehensive cervical cancer control includes screening for abnormal cervical cells and pre-cancerous lesions through Visual inspection of the cervix with acetic acid or household table vinegar (VIA) and the conventional pap smear. The primary prevention is the prophylactic HPV vaccine (for 9 to 14 years old girls) strategy under the auspices of MoHSS and safe sex education for girls and boys to reduce the risk of HPV transmission (along with other sexually transmitted infections and HIV).
Currently, the Namibian target population for cervical cancer screening is from 20 years in HIV positive women and 25 in HIV negative women. Frequency and routine follow up are given based on the results.
The visual inspection with acetic acid or table vinegar (VIA) is an appropriate screening method in resource-constrained settings considering our health facilities in remote areas. It is feasible; the nurse dips cotton wool in vinegar and applies it on the cervix for one minute.
If any pre-cancerous lesions are found on the cervix, the lesions are treated immediately by the nurse or doctor. This is an immediate “screen and treats” approach and no women deserve to go undiagnosed until they show up later with invasive cervical cancer.
Let us all do our part and encourage our women to prioritize their reproductive health. The loss of a young woman to cervical cancer is a tragedy and it can be avoided, as there is compelling evidence that cervical cancer is preventable when it is detected too early and managed effectively.