NEED TO KNOW ABOUT CERVICAL CANCER?

September is Cervical Cancer Awareness Month. Here's what you need to know about the second most common cancer in women after breast cancer.

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First the good news: cervical cancer is 100% preventable and curable when detected early. However, the tragic news is that in South Africa it kills approximately 5 000 women a year – even more than breast cancer. In wealthy countries, cervical cancer is nearly under control because of routine check-ups.

Sadly, 90% of new cases and deaths worldwide now occur in low- and middle-income countries, most in Sub-Saharan Africa. “Early detection saves lives,” says Professor Lynette Denny, a gynaecology and cancer specialist at the University of Cape Town, who received a national honour from President Cyril Ramaphosa for her trailblazing research on cervical cancer.

“Over 80% of women with cervical cancer in SA are black women and most are poor with limited access to healthcare. The most common age group is 40 to 50 years,” she says, “and no, the battle is not being won.”

WHAT IS CERVICAL CANCER?
Abnormal cells on the lower womb (cervix) may become cancerous, grow into a tumour and eventually spread to other parts of the body. Unlike breast and ovarian cancer, cervical cancer is not inherited. Almost always, it’s caused by the human papilloma virus (HPV).

This very common virus is spread through skin-to-skin contact and infects most women and men at some life stage without them even knowing. Symptoms of cervical cancer can include irregular bleeding, heavier periods, bleeding or pain during sex, smelly vaginal discharge and having to pee often.

WHO’S AT RISK?
Mostly women over the age of 30, although it can affect younger women. The risk is six times higher for HIV-positive women, who typically are also younger when diagnosed with cervical cancer (15 to 49 years). To reduce risk, the Cancer Association of SA (CANSA) recommends delaying the first sexual encounter and reducing the number of sexual partners, among other things (see box right).

HOW TO PREVENT IT?
Go for regular check-ups! A Pap smear can identify abnormalities on your cervix. “Unfortunately, most women diagnosed with cervical cancer today have not had regular Pap smears or followed up on abnormal results,” says Lorraine Govender, CANSA’s national health promotion manager.

“It’s very important that women don’t stay away when they receive abnormal results. The gap between screening and treatment is very high in SA.” She says that abnormal cells can often be removed before cancer cells develop. “Treatment should start as soon as possible for optimum results.”

A Pap smear shouldn’t hurt. Regular screenings are recommended at least every three years for women aged 18 to 70 who have been sexually active. In South Africa, women are entitled to three free Pap smears 10 years apart (around age 30, 40 and 50) at government clinics. However, anyone with symptoms should immediately request a Pap smear at a local clinic. HIV-positive women get a free Pap smear at diagnosis and every three years afterwards.

Maintaining A Healthy Cervix

– Practice safe sex: Sexually transmitted infections (STIs) can cause cervical cancer and other health problems. Use a barrier method of contraception like condoms during sex to reduce the risk of STIs. – Don’t smoke: Smoking is a known risk factor for cervical cancer. Quitting smoking can reduce the risk of cancer (and other health problems).

– Maintain a healthy weight: Being overweight or obese increases the risk of developing cervical cancer. Eating a balanced diet and staying physically active can help maintain a healthy weight.

– Avoid douching: This can upset the natural balance of bacteria in the vagina and increase the risk of infections. Instead, maintain good hygiene by washing the external genital area with warm water and mild soap.

THE VACCINE HPV
Vaccines dramatically reduce cervical cancer risk. In 2014, SA started vaccinating schoolgirls in Grade 4 (age 9) against HPV at no cost. For more information: Call CANSA for advice, counselling or to arrange a Pap smear. Free helpline 0 0800 22 66 22

Illustrations: Gallo/Getty Images