The face of cervical cancer in South Africa

Pathology: EM: Papilloma Virus (HPV) Electron micrograph of a negatively stained human papilloma virus (HPV) which occurs in human warts. Warts on the hands and feet have never been known to progress to cancer. However, after many years cervical warts can become cancerous. (Image: Laboratory of Tumour Virus Biology, via Wikimedia Commons)

Current estimates indicate that every year 5743 women are diagnosed with cervical cancer and more than 3000 die from the disease. Cervical cancer ranks as the second most frequent cancer among women in South Africa, and the second most frequent cancer among women between 15 and 44 years of age.

From 16-18 March 2011, Wits will host Professor Harald zur Hausen, 2008 Nobel Laureate and Professor Emeritus at the Deutsches Krebsforschungszentrum (German Cancer Research Centre) in Heidelberg, Germany. He has dedicated his life to research on cancer of the cervix and is credited for identifying the link between human papillomaviruses (HPV) and cervical cancer, for which he received a Nobel Prize. Prof Zur Hausen will deliver a series of lectures to which the media and the public are invited.

About 21% of women in the general South African population are estimated to harbour cervical HPV infection at a given time, and 62.8% of invasive cervical cancers are attributed to HPV subtypes 16 or 18.

Concern growing of increasing epidemic

"Concern is growing as there appears to be an increasing epidemic of papillomavirus induced disease involving not only the cervix but elsewhere in the female genital tract and anogenital region," says Prof. Martin Hale, Head: Department of Anatomical Pathology at Wits and the National Health Laboratory Service.

Papillomavirus related disease has become increasingly noted, not only in South Africa, but in the African continent as a whole, and is exacerbated as a result of the HIV pandemic, especially in Sub-Saharan Africa.

Prof. Hale worryingly indicates that cervical cancer is more prevalent in black women and there is evidence that there is a more rapid progression of premalignant dysplasia to invasive cancer in HIV positive patients.

Education is vital

Limited access to information and resources make it easy for the condition to thrive. Other risk factors that increase susceptibility include age of first intercourse and the number of children per woman and a weakened immune system, to name a few.

"Public education, a regular pap-smear and modifying human behaviour will assist in mitigating the rise in cervical cancer cases," he says.

The good news is that HPV vaccines that prevent against HPV 16 and 18 infection are now available and have the potential to reduce the incidence of cervical and other anogenital cancers. However, the debate is still raging on how, to whom and whether the vaccine should be administered.

The media and the public are invited to the following lectures by Prof. zur Hausen:

Cancer prevention by vaccination
Date: 17 March 2011
Time: 8.30am
Venue: Marie Curie Lecture Theatre, Wits Medical School, Parktown

The role of infectious agents in human cancer (public lecture)
Date: 17 March 2011
Time: 6pm
Venue: Charlotte Maxeke Johannesburg Academic Hospital Auditorium, Wits Medical School, Parktown

The history and development of tumour virology
Date: 18 March 2011
Time: 12 noon
Venue: Marie Curie Lecture Theatre, Wits Medical School, Parktown