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Cervical Cancer

The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a foetus can grow). The cervix leads from the uterus to the vagina (birth canal) below.

Women have a 1 in 40 lifetime risk of cervical cancer (NCR 2017).

Cervical cancer is the 2nd most common cancer among South African women, but the cancer women die of most in our country.

It can be successfully treated if detected in the early stages, so it is important that women are aware of symptoms and what is normal for their bodies and go for regular cancer screening.

CANSA launched its Cervical Cancer Awareness & Support Campaign on International Human Papilloma Virus (HPV) Day, on 4 March 2021. Read media release…

CANSA aims to:

  • address awareness of HPV and the link with cervical cancer
  • educate regarding risk factors and symptoms of cervical cancer
  • promote early detection through screening
  • enable patients and their families to understand their rights within the public health care system
  • provide palliative support to patients throughout treatment

Did You Know?

  • Cervical cancer is the leading cause of cancer related deaths, and the second most common diagnosed cancer (excluding basal cell carcinoma) among South African women.
  • HPV is the primary cause of cervical cancer in women, resulting in 300 000 deaths due to cervical cancer globally per annum.(1)
  • HPV strains 16 and 18 are most frequently associated with the development of cervical cancer.(2)
  • HIV infected women are at an increased risk for HPV infection at an earlier age (13-18 years) due to a suppressed immune system and are diagnosed with cervical cancer at an earlier age (15-49 years).(3)

Symptoms include: abnormal bleeding between periods, heavier and longer menstrual period, vaginal discharge, vaginal bleeding or pain during intercourse / after menopause, increased urinary frequency.

Risk factors: Cervical cancer is mainly caused by the Human Papilloma Virus (HPV), a common virus spread through skin to skin contact, body fluids and sexual intercourse. Failure to use protection during sexual intercourse, sexually transmitted infections (STIs), multiple sexual partners, early sexual debut, and use of oral contraceptives increases risk.

Women with HIV infection also have a higher risk of developing cervical cancer.

Furthermore, being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals increases risk.

Reduce Risk Through Pap smears

Having regular Pap smears can detect abnormal cells in the cervix (lower part or mouth of the womb), that could develop into cervical cancer. Screening involves taking a swab of the cervical cells. It is uncomfortable, but painless.

When abnormal cells are identified and removed, in many cases it is prior to cancer cells actually developing. Early diagnosis and treatment of pre-cancerous lesions prevents up to 80% of cervical cancers, in high resource countries, where cervical cancer screening is routine.

As part of our screening programme, CANSA makes use of the most trusted and clinically proven liquid-based cytology method when collecting a sample during a Pap smear. Pap smears help us identify abnormal cells on the cervix (lower womb) caused by HPV which can lead to cancer. Should the result indicate an abnormality, CANSA can help with a referral within the public health care sector or to a medical practitioner.

It’s very important that women do not stay away when they receive abnormal results. Cervical cancer is highly treatable if caught in the early stages and treatment should start as soon as possible for optimum results.

Contact your local CANSA Care Centre to arrange for a Pap smear, or if you live in a remote area enquire about scheduled CANSA Mobile Health Clinic visits to your area. Your health practitioner can also assist you.

The National Department of Health’s Cervical Cancer Prevention and Control Policy allows for women aged 30 years and older to have three Pap smears in their lifetime at 30, 40 and 50 at public health clinics at no cost (non -symptomatic). If women experience abnormal symptoms, they can request a Pap smear at local government clinics. HIV positive women are eligible for a Pap smear at diagnosis and every three years thereafter if negative for cervical cancer (yearly if screening is positive). Find more information in CANSA’s Cervical Cancer Position Statement & Fact Sheet.

Who should have a Pap smear?

  • all women who have been sexually active, should start having Pap smears between ages 18 to 20 years
  • every eligible woman should preferably have a Pap smear at least every 3 years

Note:

  • It is better to have a Pap smear at a less optimal time, than not at all
  • Routine cervical screening is not required for women under the age of 18 years, even if they are sexually active
  • If a woman is 70 years old and, within the last 5 years, had two normal Pap Smears, she need not continue with Pap smears

Reduce Risk Through Vaccinations

The primary underlying cause of cervical cancer is the Human Papilloma Virus (HPV), which is transmitted through skin to skin contact and is a very common virus infecting most people at some point in their lives.

There are many types of HPV and some of the virus types can infect the cells that could lead to cancer. About 40 types are sexually transmitted through genital contact, while mostly two types (16 + 18) are considered high risk in South Africa.

High risk HPV is estimated to cause: 70% of cervical cancers; 50% of vaginal & vulvar cancers; and 20% of head & neck cancers.

CANSA supports the Department of Health’s HPV School Vaccination Programme to help reduce cervical cancer risk. Persistent infection with HPV may lead to cervical cancer, so all females in the age group of 9 – 26 years (provided they are not sexually active) may be vaccinated – read more… – women who have had the vaccination should continue to be screened for cervical cancer.

Furthermore, CANSA advises delaying sexual debut; reducing the number of sexual partners, and increased condom use. Medical male circumcision helps to reduce Human Immunodeficiency Virus (HIV) acquisition and transmission, and is protective for Human Papilloma Virus (HPV) in males, thus reducing the risk of initial or re-infection of HPV among women.

Human Immunodeficiency Virus (HIV) & Human Papilloma Virus (HPV)

Women living with HIV are at increased risk of developing cervical cancer and  experience more rapid progression of the disease.

Symptoms | Risk Factors & Treatment

CANSA funds several cervical cancer research projects at tertiary institutions.

Diagnosis & Support

If you have been diagnosed with cervical cancer, please contact your local CANSA Care Centre so that our staff can offer you and your loved ones care & support, including medical equipment hire, wigs, counselling, support groups, online support groups and resources, as well as CANSA Care Homes where patients receiving treatment far from home can stay during treatment.

Staff can also help guide you through the public health care system.

We provide a counselling service dedicated to providing advice to cancer Survivors. Speak to a counsellor at your local CANSA Care Centre or call our Help Desk on 0800 22 6622 to make an appointment for Tele Counselling, or email us at counselling@cansa.org.za. You can also join our Champions of Hope Facebook Group for cancer Survivors & chat to peers who are facing similar challenges.

References:

(1) International Papilloma Virus Society (IPVS) 2021 Campaign Guide
(2) National Department of Health South Africa (2017) ‘Cervical Cancer Prevention and Control Policy’
(3) Cohen PA, JhingranA, Oaknin A, Denny L. Cervical cancer. Lancet. 2019; 393 (10167): 169-82

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