Cervical cancer is the second most prevalent form of cancer among women in Nigeria, trailing only breast cancer.
According to some estimates, 14, 943 new cases of cervical cancer are diagnosed yearly in the country and at least 10, 403 deaths are attributed to the disease yearly. These likely conservative statistics underscore the urgent need for efficient strategies to combat cervical cancer in Nigeria.
Medical research has identified risk factors including persistent infection with high-risk human papillomavirus (HPV) strains. Other risk factors include poor access to preventive healthcare services, limited awareness, socioeconomic factors, and cultural barriers that may make it difficult to constructively and objectively navigate women’s reproductive health in some parts of the country. Women in rural areas may grapple with peculiar barriers such as long distances to healthcare facilities and financial constraints. Infection with HIV/AIDs also reportedly amplifies risks.
Although vaccines that prevent infection with certain high-risk HPV strains are available in Nigeria, vaccination rates are reportedly low. Factors that contribute to low vaccination rates include affordability, poor access, and limited awareness. Some cultural perceptions also contribute to low vaccination, as for example, young girls many of whom are sexually active at an early stage and could benefit from early immunization are for a variety of reasons unable to access vaccination. Poor access to other healthcare services including routine gynecological examinations and screenings also contributes to the mortality burden since late-stage diagnoses has been identified as a major risk for death or complications. Limited awareness and understanding of cervical cancer, its risk factors, and the importance of preventive measures contribute to late-stage diagnoses, but this can be addressed if appropriate action is taken. For example, comprehensive public health education campaigns can help dispel myths and promote early detection.
There are many potentially important aspects of the incidence, risks, and management of cervical cancer in the Nigerian context, but a critical assessment indicates that it is fundamentally important to develop targeted interventions and prevention strategies. To do so, it is crucial to correctly understand the factors or elements that contribute to the incidence of cervical cancer amongst Nigerian women.
First, we are not even clear on the current morbidity and mortality burden for the disease. Again, it is easier to manage what is properly measured and data on current deaths and complications due to cervical cancer is highly desirable. Another thing is that although I am in the process of clarifying, it may be inaccurate to assume that research on a separate demographic of women is transferrable or applicable to Nigerian women. Properly tailored, context-specific research on risk factors and associated relevant factors for cervical cancer prevention and management is required.
Recent studies on the prevalence of HPV strains among Nigerian women report that the most common types of HPV detected among sampled Nigerian women were HPV71 (17%), HPV82, HPV16, HPV6 and HPV201. The study also detected a diverse group of 25 HPV types including HPV types 91, 114, 118, 152 and 196. Some strains such as HPV types 16 and 18 are more high risk or more strongly associated with the development of cervical cancer and it is good that more studies monitor the prevalent HPV types being transmitted among women in Nigeria. It is also important to explore and begin to characterise the main factors that contribute to delayed medical intervention amongst women. It is important to make routine screening programs more available and accessible. It is also important to tackle cultural beliefs and practices that can influence women’s health-seeking behaviours, as well as cultural norms that hinder open, constructive conversations about gynecological concerns and sexual health overall.
Over the next several weeks, I would be asking gynecologists and other health experts specific questions. Some current ideas include: Do we have an efficient national screening program? Are current efforts for education about cervical cancer useful/adequate? What are the essential components of a comprehensive strategy to combat cervical cancer in Nigeria? What are the factors responsible for, or that contribute to late detection of cervical cancer? Other questions may likely arise, but overall, I expect that questions would revolve around vaccination rates and programs, access to screening services, as well as education and training.
Cervical cancer is one of Nigeria’s foremost public health concerns and it demands immediate well-coordinated action. By prioritizing awareness, prevention, and early detection, it is possible to minimize the burden of cervical cancer among Nigerian women.
Reference:
- https://doi.org/10.1186/s12985-023-02106-y ↩