Focus on cervical cancer in Women’s Month

This year South Africa’s Women’s Month celebrates 30 years of democracy. “Great strides have been made in advancing gender equality, economic opportunities, and empowerment of women,” says Govender. “However, many still overlook their health. Often, it’s a matter of having little or no time to go for medical check-ups and ignoring niggling symptoms. And there are also those women who just don’t know about cancer and how to recognise its symptoms.”

Knowledge gaps surrounding women’s health and cancer can prevent women from seeking appropriate healthcare services or discussing their symptoms openly. This delays the diagnosis and treatment of cancer, leading to worse outcomes. Govender says that CANSA consistently promotes cancer awareness and early detection through education and screening. 

“During Women’s Month, we are especially focusing on cervical cancer, which is preventable and treatable if detected and addressed early.” 

Cervical cancer is one of the top three affecting women in South Africa. Second to breast cancer, the 2022 South African National Cancer Registry statistics state that 7,499 new cervical cancer cases were diagnosed histologically. Most women being diagnosed are aged between 40-49. 

According to the World Health Organization (WHO), the annual number of new cases of cervical cancer across the globe has been projected to increase from 570,000 to 700,000 between 2018 and 2030; and the annual number of deaths because of cervical cancer is projected to increase from 311,000 to 400,000 (World Health Organization, 2020). More than 85% of those affected are young undereducated women who live in the world’s poorest countries. We can expect a similar trend in South Africa unless we increase the uptake of the Human Papillomavirus (HPV) vaccine.

CANSA’s Women’s Health awareness campaign is aligned with South African initiatives, as well as with the WHO’s 2020 global strategy for the elimination of cervical cancer. The WHO’s strategy aims to see 90% of girls fully vaccinated against HPV by the age of 15; 70% of women screened with a high performance (i.e. screening through PAP Smears or HPV DNA testing) by age 35 and again at 45; and 90% of women identified with cervical disease receiving treatment. CANSA aims to support this strategy by creating awareness around the signs and symptoms of cervical cancer, promoting early detection through regular screening and educating women on the importance of treating precancerous lesions to ensure effective treatment outcomes.

CANSA Ambassador and Mrs South Africa 2023 finalist, Roulene Bonthuys is a survivor of cervical cancer. She states “So many women are not aware of this cancer until it is too late. Please don’t wait for next month or next year to visit your gynaecologist and find out as much as you can about cervical cancer and how to prevent it.” 

Almost all cervical cancers are caused by the Human Papilloma Virus (HPV). HPV is a common virus that is spread mainly through skin-to-skin contact of the lower genital tract during sexual contact. Smoking is another risk factor. There are many different types of HPV. Some strains lead to cervical cancer, some may cause genital warts, while others do not cause any problems at all.

Symptoms may include abnormal vaginal bleeding between periods or after menopause, menstrual periods becoming heavier and lasting longer than usual, vaginal bleeding or pain during or after sexual intercourse, and abnormal vaginal discharge. However, cervical cancer does not always present with easily detected symptoms, that’s why regular screening is important. 

“Most women and men are exposed to the HPV, and most will clear the infection. In women with a compromised immune system, the virus may not clear, and a persistent infection can integrate into normal cells and become cancerous cells. In addition, HIV, diabetes, and transplant patients on immune suppressant drugs for example, are at risk of not clearing the virus,” says Dr Tracey Adams, senior specialist in the Department of Obstetrics and Gynaecology at Groote Schuur Hospital in Cape Town, and a Gynaecological Oncology subspecialist consultant. 

Ways in which to reduce the risk of cervical cancer, are the HPV vaccine given to girls at the age of nine, and regular screening tests like pap smears. The pap smear test looks for precancers and cell changes on the cervix that might become cervical cancer if they are not treated appropriately. CANSA offers pap smears at most CANSA Care Centres and pop-up clinics across South Africa at affordable rates - inclusive of a clinical breast examination and laboratory fees.

The National Health Council of the Department of Health decided in October 2023 that South Africa should transition to HPV testing as the primary method of cervical screening. The routine age to start screening starts at 30 for HIV-negative women (screening should be offered to all women aged 30 and older if they have not yet been screened). If the screening result is negative, routine screening is offered every 10 years. If three routine screenings are negative and the woman has reached age 50, no further screening is required

For women living with HIV, routine screening should start from age 25 (screening should be offered to all women living with HIV aged 25 and older if they have not been screened). If the screening result is negative, routine screening is offered every three to five years. If the woman has passed the age of 50 and has had three consecutive negative routine HPV screenings, no further screening is required.

CANSA offers cancer screening at some of its CANSA Care Centres to mark Women’s Health Month.

Comprehensive information about cervical cancer and all other types of cancers affecting women is available at: https://cansa.org.za/womens-health/