Cervical Cancer Awareness

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.

Cervical cancer is a major risk to a woman’s health. High-income countries have procedures in place to screen women for this risk. Yet most women who live in low-income countries do not have these screenings, which leaves them more likely to die of cervical cancer.  Overall, it is important that we think about feasible solutions that can be used in low-income settings.

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Worldwide Gynecological Awareness Month: Interview with Dr George Sawaya

Every year over a million women worldwide are diagnosed with a gynecological cancer. September is Worldwide Gynecological Awareness Month, which incorporates the awareness of the following five major cancers: cervical, ovarian, uterine, vaginal, and vulvar. 

Women in all parts of the world are at risk of gynecological cancers, but this risk is exacerbated in areas of the world where access to prevention and treatment is low. Over 80% of cervical cancer cases occur in the developing world, and lack of regular Pap smears and other interventional measures may contribute to this statistic

To cap off Worldwide Gynecological Awareness month, I spoke with Dr. George Sawaya, Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of California San Francisco. His current research is in cervical cancer screening with particular interest in new technologies, cost-effectiveness and utility, novel approaches to population-based screening and risk communication. Dr Sawaya has also served on the cervical cancer guidelines committee for the American Cancer Society and the US Preventive Services Task Force.


Ruby Singhrao: Death from cervical cancer is high in many developing countries but lower in North America, Europe and Australia. What measures have been taken in these countries to reduce the risk of cervical cancer?
Dr George Sawaya: The United States has had widespread screening for cervical cancer using the Pap smear since the 1950’s. The risk of cervical cancer is driven by how much screening is available in the population, at least for now. We don’t know yet what the effect of HPV vaccination will be on cervical cancer, so currently the cornerstone of prevention is ] early detection of pre-cancerous lesions with treatment before they turn into cancer.


RS: So it seems that cervical cancer is one of the few gynecological cancers that can be prevented.
DR GS: Yes, cervical cancer is the poster child for gynecologic cancer prevention since it aims to detect and treat pre-cancerous lesions., Screening for colorectal cancer works in a similar way. Screening for breast cancer, on the other hand, aims to detect early cancers, so the benefit is mainly in preventing cancer deaths.

On Gynecological Awareness Month

Every year over a million women worldwide are diagnosed with a gynecological cancer. September is Worldwide Gynecological Awareness Month, which incorporates the awareness of the following five major cancers: cervical, ovarian, uterine, vaginal, and vulvar.

Women in all parts of the world are at risk of gynecological cancers, but this risk is exacerbated in areas of the world where access to prevention and treatment is low. Over 80% of cervical cancer cases occur in the developing world, and lack of regular pap smears and other interventional measures may contribute to this statistic. This series will explore these types of Gynecological cancers, compare western treatments to those in the developing world, as well as highlight resources for women. An interview with Dr. George Sawaya, Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of California San Francisco will also be included.