By Joke Kujenya
CHIAMAKA OBI suddenly noticed unusual bleeding and persistent fatigue. But she said she delayed seeing a doctor because she was unaware that a common virus could threaten her life. Today, she said her condition is compounded as she’s managing her health.
Similarly, across Nigeria, thousands of women face dicey risks from cervical cancer, a disease caused by persistent infection with human papillomavirus (HPV).
Also, globally, cervical cancer ranks as the fourth most common cancer among women, with 660,000 new cases and 350,000 deaths recorded in 2022.
So far, low- and middle-income countries accounted for roughly 94% of these deaths, highlighting the stark inequities in access to prevention, screening, and treatment services.
Medically, persistent HPV infection affects the cervix, the lower part of the uterus opening into the vagina and can lead to precancerous lesions.
If left untreated, these lesions result in about 95% of cervical cancer cases.
For most women, it takes 15–20 years for abnormal cells to develop into cancer, though those with weakened immune systems, including women living with Human Immunodeficiency Virus (HIV), may experience progression within 5–10 years.
Moreover, women living with HIV are six times more likely to develop cervical cancer compared to women without the virus, and an estimated 5% of all cases are attributable to HIV.
On younger women, cervical cancer disproportionately affects them more, contributing to 20% of children losing their mother to cancer.
Risk factors that accelerate progression include the grade of HPV type, immune status, presence of other sexually transmitted infections, number of births, early age at first pregnancy, hormonal contraceptive use, and smoking.
However, prevention is widely available as HPV vaccination for girls aged 9–14 is highly effective at preventing infection and subsequent cervical cancer.
By 2025, eight licensed vaccines exist, five of which are World Health Organisation (WHO) pre-qualified and protect against HPV types 16 and 18, responsible for approximately 76% of cases.
The organ also noted that vaccines may be administered as one or two doses, while immuno-compromised individuals, including those living with HIV, are recommended to receive two or three doses.
WHO said that some countries also vaccinate boys to reduce HPV prevalence in the wider community and prevent HPV-related cancers in men.
Regular cervical screening, according to the WHO, is a crucial safeguard urging that women should undergo high-performance tests every 5–10 years starting at age 30, or from age 25 for women living with HIV.
It says the global strategy calls for a minimum of two lifetime screenings by ages 35 and 45. Self-collection of samples for HPV testing has proven as reliable as provider-collected samples, giving women more options to participate in prevention programmes.
Treatment of precancerous lesions is also simple, effective, and often quick as thermal ablation destroys abnormal cells using heat, while cryotherapy uses cold probes.
Explaining LEEP or LEETZ procedures, the WHO says it excises tissue with an electric loop, and cone biopsies remove cone-shaped tissue for assessment.
Some programmes provide treatment on the same day as screening, known as the screen-and-treat approach, while the screen, triage, and treat method is preferred for women living with HIV.
Early detection remains critical with women experiencing unusual bleeding between periods or after sexual intercourse, foul-smelling vaginal discharge, persistent back, leg, or pelvic pain, weight loss, fatigue, loss of appetite, vaginal discomfort, or swelling in the legs should seek medical attention immediately.
Diagnostic tests also confirm the disease, followed by treatment options such as surgery, radiotherapy, chemotherapy, and palliative care.
Multidisciplinary teams oversee diagnosis, staging, and treatment decisions in line with national guidelines, while psychological, spiritual, and physical support complements clinical care.
As cervical screening expands in previously unscreened populations, more invasive cases are being detected with effective referral and management pathways are essential to connect women with prompt treatment and to prevent delays that could prove fatal.
As the situation persists, WHO urges all countries to reach the 90-70-90 targets by 2030 by ensuring that 90% of girls fully get vaccinated by age 15, 70% of women screened by ages 35 and 45, and 90% of women with precancer or invasive cancer receiving treatment.
It also adds that achieving these targets could prevent 74 million new cases and 62 million deaths globally by 2120, with substantial benefits for women living with HIV.
Lifestyle measures complement medical interventions by avoiding smoking, practising safe sex, and voluntary male circumcision reduce the risk of HPV infection.
Other options include public awareness campaigns and improved health literacy remain vital to prevention, alongside early detection and timely treatment.
While January is Cervical Cancer Awareness Month (CCAM), the World Cervical Cancer Elimination Day (WCCED), observed annually on 17 November, draws attention to the urgency of vaccination, screening, and treatment.
WHO says the observance encourages collaboration among countries with it and partners to expand access to services and track progress toward elimination.
It adds that for women all over the world, timely vaccination, regular screening, and immediate medical attention for symptoms remain the strongest tools against a disease that can otherwise claim life unexpectedly.
The organ also urged families to support access to vaccination for girls aged 9–14 and encourage women to participate in screening programmes.
Adding that cervical cancer is largely preventable yet still deadly, the WHO said the condition continues to shape the lives of Nigerian women and reiterated that awareness, early detection, and access to treatment are gems that will turn potential tragedy into survival, and as well offers hope amid the statistics that show the human cost of inaction.
