18,000 women dying of cervical cancer in PNG

AROUND 18,000 women are dying every year in Papua New Guinea from cervical cancer which is preventable and treatable, doctor says.
Chief consultant obstetrician and gynecologist at Pacific International Hospital (PIH) and deputy chairman of the National Health Board Dr Mathias Sapuri said this figure meant that around five women were dying every day from cervical cancer.
Dr Sapuri said the number of women dying can be reduced with improved accessibility to cervical cancer screening for early detection and treatment and also through the rolling out of Gardasil vaccination programme.
He said to eradicate cervical cancer in PNG in the next 20 years, the Gardasil vaccine must be brought in by the government integrated in the national immunisation programme for the vaccination of girls at nine years to young women of 26 years.
He also emphasised on the need for more awareness on cervical cancer and other cancers that affected women to reduce the high burden of cancer in the country.
In this article, Dr Sapuri talked about the cervical cancer situation in PNG, the risk factors for getting this cancer, ways of prevention, symptoms, Pap smear test, human papilloma virus (HPV) and Gardasil vaccine with its need in the country.

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Cervical Cancer in PNG

Cancer of the neck of the baby’s womb (cervix) is the most common and leading cancer in women in PNG over the past five years surpassing breast cancer.
Despite it being the most controllable and treatable form of cancer, with regular testing, it is the number one cancer in women in the country.
The common age group to get cervical cancer is between the ages of 30 and 50.
However, the recent trend shows earlier onset as young as 20 years to 30 years of age.
Cervical cancer is caused by chronic infection with a virus called humanpapilloma virus (HPV).
If the HPV is found in the stage of virus infection or when there are only early microscopic changes in the cervix, it can be easily treated surgically.
However, if found in the later stage, it can be harder to treat and can unfortunately be fatal.
Risk factors for getting this cancer are:

SMOKING;
WOMEN who began sexual activity when they are very young i.e. before age 18 years;
WOMEN whose husbands have had many partners; and,
WOMEN who have had many partners themselves
Ways of preventing cervical cancer :

GIRLS should avoid having sexual intercourse or getting married until they are over 18 years;
EVERYONE should have less sexual partners (both men and women);
AVOID smoking;
USE a condom during sexual intercourse; and,
GO for VIA (visual inspection of the cervix) or PAP smear test every two years once a women sexually active especially those that are above 20.
Symptoms of early cervical cancer

In early stages of the disease (when it is possible to prevent the cancer invading your body), the woman feels nothing: this is why it is so important to Gardasil vaccination with screening and not wait until you get symptoms.
As the cancer starts to invade into the cervix, some women may start noticing a small blood stained discharge after sleeping with their partners.
When the disease becomes more advanced, a woman may have the following symptoms;
lBLEEDING from the vagina between periods (anytime, not at period time); and,
lA BAD smelling vaginal discharge.

Treatment

Treatment of early cervical cancer is easy, but if it becomes advanced, it is difficult to remove and needs to be treated with either surgery, chemotherapy, radiotherapy or a combination of any of these.
The earlier cervical cancer is detected the more likely it can be cured.
How the VIA check for cancer or the PAP smear test is performed
When VIA is performed, the nurse or doctor inserts a speculum so that the cervix can be easily seen then washes the cervix with diluted vinegar. After one minute, the changes due to HPV infection become visible.
If you have HPV infection changes or signs of early cancer on your cervix, the doctor (or nurse) can then put in the ice treatment or diathermy to eradicate the problem.
In a Pap smear test, the speculum is inserted and the nurse brushes the cervix and then paints the brush onto a glass slide.
Then this glass slide needs to be sent to a specialist laboratory in Port Moresby General Hospital or PIH.
It takes seven to 10 days to get the result of the PAP smear test result.
If the PAP smear test shows that there is early signs of cancer starting then that woman will need to go to see a specialist gynaecologist for surgery.
Dr Sapuri emphasised that it was possible to diagnose cervical cancer at a very early stage (when it is possible to easily remove it) by doing the simple VIA or PAP smear test every two years, once a women is sexually active.
He said these simple tests would detect any infections and abnormalities some of which are not cancerous but will need medication and surgery.

The National / PNG health Watch

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