Because only women have a Cervix, cervical cancer affects women in the cervix, the lower, narrow end of the uterus that connects to the vagina.

• Around 660,000 women were newly diagnosed with cervical cancer in 2022, making it the fourth most common cancer in women globally.
• Cervical cancer is a largely preventable non-communicable disease, with effective strategies available for primary (vaccination), secondary (early detection), and tertiary (management of diagnosed cases) prevention.

Everyone talks about Cancer and almost always generally. Breast cancer, lung cancer, and prostate cancer, these were familiar terms. Not much or anything at all is ever said about cervical cancer.

What is Cervical Cancer?

Cancer is a group of diseases where some of the body's cells grow uncontrollably and spread to other parts of the body.

• It accounts for death every two minutes and nearly 22.5% of those deaths occur in Africa.
• About 8% of the cancer is associated with infections with high-risk strains of human papillomavirus (HPV)
• More than  75,000 new cases and close to 50,000 deaths are reported annually in sub-Saharan Africa
• The World Health Organization projects that by 2030, cervical cancer will claim the lives of more than 443,000 women worldwide, with almost 90% of these fatalities in sub-Saharan Africa.

A surge in cervical cancer cases threatens to reverse the advancements made by African women in reducing maternal mortality and enhancing life expectancy.

What causes Cervical Cancer?

The primary cause of cervical cancer is a long-lasting infection with specific types of human papillomavirus (HPV). HPV is a transmitted virus that spreads through sexual contact.

Doctors estimate that at least half of sexually active individuals will contract HPV at some point in their lives; however, only a small percentage of women will develop cervical cancer.

Who is at risk for cervical cancer?

Cervical cancer is often associated with identifiable risk factors. Some of these factors can be modified, while others are beyond your control.

Here are some risk factors you can control:

• Sexual intercourse at an early age:
• HPV infection
• HIV infection
• Weakened immune system
• Multiple pregnancies
• Long term use of birth control pills
• Smoking: Cigarette smoking has been linked to a heightened risk of cervical cancer.

While these risk factors are controllable, some are not. Example of an uncontrollable risk factor:

• Family history
• Age

How is cervical cancer diagnosed?

Her gynecologist had told her that her last heavy flow was due to something called an anovulatory cycle, which happened because when she had her period her ovaries did not release an egg and It was “nothing to worry about”. So when it happened again in June, she didn’t think much of it until it refused to stop after the expected 3 - 5 days. Mrs B bled for days. 

She returned to the hospital and had several tests done. A full blood count, an ultrasound scan, her PCV, which indicates the blood level in her body, was normal. The abdominal ultrasound done didn’t show anything abnormal. The labs looked through her results and found nothing extraordinary. Until she did a urinalysis, and they discovered red blood cells in her urine.

The doctor again reassured her and recommended she go for a biopsy, where a tiny cut of her cervix will be taken and viewed with a microscope. The biopsy report came back and the unimaginable had happened: Mrs B had cervical cancer. 

The urinalysis done  in the lab, the red blood cells found in her urine, how did they know what it was? Why was her urine unusual today of all days?

Cervical cancer develops slowly over many years, hence the need for regular Pap smear.

A Pap smear is a process that screens for cervical cancer by collecting cervical cells from the lower part of the uterus that connects to the vagina. It can also reveal precancerous changes in these cells, enabling early intervention when required.

The doctor explained to Sola that in the test, the nurse uses a speculum to gently open the vagina, providing access to the cervix. They then collect cell samples using a soft brush or spatula, which they preserve in a solution and send to a laboratory for analysis.

The entire process typically takes just a few minutes and may cause slight discomfort, but it is usually not painful.

To detect early signs of cancer, if positive, a biopsy is ordered.

The biopsy could be any of the following:

• Colposcopic biopsy
• Loop electrosurgical excision procedure (LEEP)
• Cone biopsy
• Endocervical curettage
• Cold knife cone biopsy

An HPV DNA test too can be ordered.

When the biopsy test comes out as positive, further investigations would be required to determine if the cancer has spread (metastasized) and to what extent.

The other test include:

• Renal function test
• Liver function test
• X-ray of bladder, bowels, intestines
• Urine Test
• Ultrasound

Support Groups -

Cancer changes dynamics of life for patient and family.

Joining a cancer support group can provide emotional relief and connection with others facing similar challenges. Sharing experiences can help alleviate feelings of isolation.