Cervical cancer is the second biggest cancer killer of women worldwide. We know that nearly all cases of cervical cancer is caused by the human papillomavirus (HPV). There are many types of HPV but we know that HPV types 16 and 18 are the most cancer causing. That’s why there is a vaccine targeted to those two types. There are many ways we can prevent cervical cancer. For younger girls who have not yet had sex, the vaccine provides good protection against the cancer causing viruses. For other women, regular screening at their doctor is important. Screening means your health professional will take a Pap smear. To do this, a cotton swab is used to gently take some cells from your cervix, no scraping is involved and it should not hurt. For other women, though more rare, they might have an HPV infection but it can just clear up on its own. But all women should get a regular screening to make sure they are healthy.
Yet given all the things we can do to prevent cervical cancer, why do so many women die of cervical cancer? The answer is, it depends on where you live. In developed countries, which includes North America, Europe, and Australia, the risk of you getting of cervical cancer is only about 5%. This is because there is regular screening to catch women who are at risk of developing it. When they are screened, if there are any abnormalities the health professional will treat to prevent progression to cervical cancer. In low income countries like Kenya, this does not happen as there are not enough resources to screen women. Therefore, over 80% of new cases and deaths due to cervical cancer are in low income counties like Kenya.
Women in Kenya suffer because there is no infrastructure in place to implement regular Pap screening. However, many health professionals have looked at cheaper and more feasible alternatives to Pap screening. In Kenya, Dr. Megan Huchko from UCSF has helped to implement a cheap diagnostic called visual inspection with acetic acid. At HIV treatment clinics such FACES, where Dr. Huchko works, women can be seen for reproductive health services. As part of a routine check-up, women who attend the clinic have their cervix ‘painted’ with acetic acid, or plain table vinegar. Any abnormal cells turn white. These abnormal cells mean that there is an increased risk of cervical cancer, so it is important that they are removed. Women are offered removal, either through “shaving off” or freezing of abnormal cells in the clinic. A few studies have shown that this is a feasible and cost-effective method of cervical screening for women in low-resource settings.
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