Cervical cancer: Zambia’s top health burden
Published On May 3, 2018 » 1488 Views» By Davies M.M Chanda » Features
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.Tonga, cancer survivor.

By CHRISTINE MWAABA –
IT is more than grisly threatening for many women to hear that cervical cancer was still perhaps one of the leading causes of death among them.
This devastating illness is caused by (HPV) infection, which results from one having many sexual partners, smoking, birth control pills, and engaging in early sexual contact.
According to Cervical Cancer Global Crisis Card, Zambia has the highest numbers in the world in terms of cervical cancer mortality rate.
The World Health Organization (WHO) says Zambia and Tanzania have the highest incidence of cancer of the cervix in Africa and sixth highest in the world.
Cancer of the cervix in Zambia continues to be one of the most common among the 200 cases handled daily at Lusaka’s cancer disease hospital.
Zambia’s largest public health institution, the University Teaching Hospital (UTH) Cancer Disease Hospital (CDH) diagnoses more than forty cases of cervical cancer every week most of which are reported in advanced stages.
Experts attribute the causes of cervical cancer to weak immune systems, smoking, multiple sexual partner, initiating sex at young age.
CDH Senior Medical superintendant Lewis Banda said cervical cancer is the most common among the more than 200 cases that the hospital handles daily.
Dr Banda said every week the hospital handles more than 40 cervical cancer patients.
“The HPV infection may cause abnormal growth of cervical cells and the HPV infection is spread through skin to skin sexual contact,” he said.
He noted that some of the most common symptoms and signs of cervical cancer are abnormal vaginal bleeding, increased vaginal discharge, bleeding after going through menopause, pain during sex,” he said.
However, cervical cancer typically does not cause symptoms in its early stages but may be detected upon screening.
When symptoms occur which may include bleeding between menstrual periods, bleeding after sexual intercourse, among others, it means that the cancer has progressed to other parts of the body.
He said cervical cancer ranks as the most prevalent cancer diagnosed among women in Zambia and also the most prevalent cancer among women between 30 and 50 years of age.
Dr Banda said a correct and timely cancer diagnosis was critical for effective treatment options.
“If cervical cancer is left untreated, these cells may progress into severe stages of the cervical cancer that cannot be treated,” he said.
He added that women living with HIV infection have a much higher risk of HPV infection and cervical cancer than those not infected.
HIV positive women tend to have suppressed immune system, thus making them more susceptible to infections.
In addition, some practices have also increased chances of women having cervical cancer except that there has not been a formal study to confirm that these practices are a contributing factor.
Dr Banda said cervical cancer can often be prevented with vaccination and modern screening techniques that detect pre-cancerous changes in the cervix before it progresses to cancer.
“Screening is a process used in detection of early forms of cervical cancer among women to detect any pre-cancerous before it develops into cancer”.
The screening tests include Visual Inspection with Acetic Acid (VIA), which is a pre-cancerous measure.
“If every woman can have routine cervical cancer screening there will be early detection and treatment before the cancer develops,” he said.
He said increased awareness of cervical cancer dangers and available services, including screening and treatment services in health facilities, especially those offering primary health care would be Key to pre-cancerous measures to save the lives of women.
Dr Banda said the introduction of the HPV vaccine was a milestone development by government and is Key to save girls before they are sexually active in a bid to protect women from contracting cervical cancer.
Cervical cancer is cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body.
Studies show that HPV infection was common and that the majority of women if not vaccinated would be infected with HPV at some point in life.
Evelyn Tonga, aged 44, was diagnosed with advanced cervical cancer in 2012. At the time, Evelyn was given a 50 percent chance of surviving.
She was working as a sales executive at the State Lotteries in Chingola on the Copperbelt when her health problems started.
Ms Tonga started bleeding badly from her abdomen, this went on for a month and was given some medicine which stopped the bleeding, but the problem continued the following month.
She consulted a gynecologist who sent her for a biopsy. Then she was informed that she had advanced cervical cancer.
The gynecologist confirmed she had advanced stage 4 cervical cancer. She was put on a long course of chemo and radiotherapy.
“I was devastated. All I knew was that this disease is incurable. After the second day of radiotherapy, the bleeding stopped and I was already feeling better. I was so relieved that I started work.
“I am very grateful because this has all been provided for free through the CDH. They have been very good to me and the support from my family has also been incredible. I now want to help others who are in my position. I want to start a charity so that people know more about cancer,” she narrated.
The WHO Sexual and Reproductive Health 2017 report states that cervical cancer screening help test for pre-cancerous and cancer among women who may have no symptoms and feel perfectly healthy, thereby enabling women receive treatment.
The report also notes that vaccination is one of the most commonly used public health strategies to reduce the risk of infection and minimize the prevalence of the disease-causing agent (HPV) in the environment.
It also suggests that vaccination campaigns should target 9–13 year old youth, prior to initiation of sex.
“HPV infection often occurs shortly after the onset of sexual activity women are infected within 2 years of initiating sexual activity,” the report said.
The reports notes that nearly all cases 99.7 Percent of cervical cancer are caused by Human Papillomavirus (HPV) which is one of the most common sexually transmitted infections, with up to 75 percent of sexually active people estimated to be infected at some point during their lives.
The vaccines are over 95 percent effective at preventing HPV infection.
It has been recommended that countries should ensure that women from 30 to 49 years are screened at least once in their life time.
Although HPV vaccination for girls reduces the possibility of developing cervical cancer later in life, this approach does not eliminate the need for regular screening later in life.
Ministry of Health Cancer Prevention Coordinator Sharon Kapambwe said the target was to screen close to 100,000 women every year. In 2017, at least 60,000 women were screened for cervical cancer countrywide.
Dr Kapambwe in an interview that cervical cancer was the most common cancer in Zambia and it accounts for over 30 percent of new cases hence the need for women to go for screening.
She said it is important for women to go for screening because there is need to ascertain what sort of treatment can be used if found positive, adding: “Early diagnosis gives us an early outcome for treatment.”
Dr Kapambwe said awareness levels are still low among women in rural areas although cervical cancer, with over 70 centres across the country being screening.
The 100,000 target can be reached if women turned up for screening. These centres are found in all provinces.
“We have found that in most centres, the uptake of cervical cancer screening has been very low and we need more women to come for screening,” she said.
She said Government will soon open 80 new cervical cancer centres and will by 2021 have a screening centre in each district to try and reach as many women as possible.
Dr Kapambwe said the Ministry of Health has started engaging in various awareness programmes on cervical cancer.
The statistics of cervical cancer in Zambia was a clear indication that there was need of setting up more cervical cancer screening facilities countrywide to offer opportunities for early detection and treatment of pre-cancerous to improve prospects for survival.
There was no need for any woman to die from preventable and treatable diseases like cervical cancer.

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