By Chioma Obinna
With 8,000 Nigeria women dying from cervical cancer annually, experts have raised the alarm that prevention and treatment of cervical cancer were largely crippled by a lack of awareness and knowledge of the disease as well as proper infrastructure in the country.
The experts who noted that cervical cancer is fundamentally 100 per cent preventable, regretted that one Nigerian woman dies every hour, totalling 24 women dying daily.
Speaking during a webinar organised by the George Kerry Life Foundation in collaboration with Beacon Premium Solutions to mark Cervical Cancer Awareness Month, they said more than 20 per cent of cases of cervical cancer are in women over 65.
In her presentation, the Managing Director/Chief Executive Officer (CEO) of JNC International LTD, Clare Omatseye, said the majority of the cases in Nigeria present at late stages 3 and 4, when the disease is only amenable to radiotherapy.
She said a lack of adequate radiotherapy facilities (especially Brachytherapy) in the country has compounded the late presentation giving the women almost no chance at survival.
Omatseye said aside from the machines, the vaccines are also not enough for the number of women who want to be vaccinated.
“With the lack of proper awareness and exposure on the matter of vaccination for cervical cancer, even the few who go to get vaccinated also have to pass through a lot of stress.”
She said this was part of the reasons why many women were nonchalant towards the silent killer.
She identified other challenges to include lack of organised national screening programme for cervical cancer, adding that the National Health Insurance Scheme has limited coverage for cancer treatment
“ The few existing cervical cancer screening programmes are opportunistic and are based on Pap smear with its technological and human resource challenge and visual inspection with acetic or Lugol’s iodine (VIA /VILI) with its challenge of low-test characteristics.”
Speaking on prevention, Omatseye added that avoiding HPV infection should be the mainstay of cervical cancer prevention using the strategies of health education and vaccination for all women up to the age of 26years.
“The ideal strategy for cervical cancer prevention and treatment in Nigeria should have the potential to prevent HPV infection, overcome the limitations of existing screening tools and identify cases early. HPV vaccination of young girls and HPV based cervical cancer screening methods have the potential to address these gaps.
Stating that current estimates indicate that every year 12,075 women are diagnosed with cervical cancer and 7,968 die from the disease in Nigeria, she added that about 3.5 percent of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 66.9 percent of invasive cervical cancers are attributed to HPV 16 or 18, according to data from ICO/IARC Information Centre. She said cervical cancer is preventable with HPV vaccine and curable if diagnosed early.
On how effective the vaccine is against the disease, Omatseye explained that vaccines provide very high immunogenicity (antibody levels) for HPV 16 and 18 in the bivalent vaccine and against HPV 6, 11, 16 and 18 for the quadrivalent vaccine.
Consultant Public Health Physician and Founder – George Kerry Life Foundation Grant’s Coordinator – Children’s Developmental Centre, Dr Maltida Kerry, who is the founder of the organisation said the diseases can be eliminated.
Speaking, Kerry said urged Nigerian women to commit the time for an annual cervical screening, do not be discouraged or deterred by the misconception that they will spend hours at the clinic.
She explained that vaccination was more helpful in women that are not yet sexually active and not yet exposed to HPV, although sexually active women can also be vaccinated for additional protection.
“Once a woman is sexually active regardless of vaccination status she should commence regular cervical cancer screening.
“The vaccine, for now, is not affordable to all. As Mrs Omatseye said there are efforts by GAVI and FMOH to reduce the cost and even add it onto routine immunization. But until this is achieved the HPV still costs about N10, 000 or more per shot and a woman needs 3 shots over 6 months.
“Despite the fact that cervical cancer is deadly, there is hope for those who have been diagnosed with the disease as it can still be eliminated with proper access to the necessary vaccines and machines,” she said.
Kerry said that getting the Human Papilloma Virus (HPV) vaccine is the first step towards preventing the disease from infecting women and girls from the age of 15 should have access to the vaccine.