Cervical cancer is preventable with proper screening, yet it is the leading cause of cancer-related death in women across sub-Saharan Africa, and those living with HIV are more at risk.
Weakened immune systems make it harder for women living with HIV to fight the virus which causes the disease. But while antiretroviral therapy means women can live long and healthy lives with HIV, many are dying unnecessarily because of a lack of cervical cancer screening.
Every day around 15 to 25 women walk into the referral hospital in Blantyre, in the southern part of Malawi. They either suspect they have the disease or health workers have referred them from rural areas, where equipment and expertise for diagnosis is unavailable. Almost seventy per cent of women diagnosed with cervical cancer are also living with HIV.
Cervical cancer is caused by human papilloma virus (HPV), a form of virus that is transmitted sexually. The virus display no signs until it reaches an advanced stage, when treating it becomes difficult.
Link between HIV and HPV
According to the Center for Disease Control and Prevention (CDC), nearly all sexually active men and women get the virus at some point in their lives. In most cases, it goes away on its own and does not cause any health problems.
But Professor Frank Taulo, an obstetrician and gynecologist at College of Medicine in Malawi, said the disease is a high burden on the younger generation due to HIV.
Speaking at a press briefing in the country’s commercial city in Blantyre, ahead of Disease Awareness Day (22 November), Professor Taulo said: “There is interaction between HIV and HPV since HIV kills the body’s defense so when HPV comes in, it stays. We’ve seen trends where those living with HIV are developing cervical cancer as early as 19, instead of in their later years. About 65 per cent of patients I see with cervical cancer are also living with HIV due to immune compromise.”
Thousands of women affected
Lutengano Kadam’manja, chairperson of the Mwayiwathu Private Hospital’s Disease Awareness Day committee, said this year they have decided to concentrate on cervical cancer because the country is losing many women to the disease.
Professor Bonus Makanani, associate professor in the department of obstetrics and gynecology at the Malawi College of Medicine, said the Malawi Cancer Registry Programme had recorded 1,200 cases per year between 2007 and 2010. He added that cervical cancer can be easily managed in its developing stages and some health facilities in Malawi are set up to do that, but that the actual cancer is difficult to treat.
Chris Kang’ombe, principal secretary in the Ministry of Health, was quoted by Malawi News Agency earlier this year as saying that cervical cancer is the most frequent cancer among women in Malawi, affecting more than 2,000 women and claiming 1,600 lives every year.
According to the CDC, worldwide more than twice as many people die from cancer as from AIDS, malaria and tuberculosis combined, but as many as 93 per cent of cervical cancers could be prevented by screening and HPV vaccination.
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