By Daniel Wako
Cervical cancer is the fourth most common cancer among women globally, as per the World Health Organization (WHO), with an estimated 604 000 new cases and 342 000 deaths in 2020 alone. About 90% of the new cases and deaths worldwide occurred in low- and middle-income countries.
In Kenya, a 2021 report by Human Papilloma Virus (HPV) Information Centre says the country has 16.2 millions women aged 15 years and older who are at risk of developing cervical cancer. It’s current estimates indicate that every year 5, 236 women are diagnosed with cervical cancer and 3, 211 die from the disease.
According to Felida Hashora, a senior nursing officer in charge of cervical cancer treatment at Bungoma Referral hospital, cervical cancer is a disease of the opening of the womb, also known as the cervix that causes rapid multiplication of abnormal cells fighting for nutrients and water.
Hashora states that HPV, sexually transmitted viral infection among men and women, is the main cause of cervical cancer which comes as either HPV 16 or HPV 18. Four out of five people have at least one type of HPV infection during their lifetime. Despite that, most HPV infections do not cause any symptoms and most people never know they are infected with it.
“Any woman can get this cancer but factors like co-infection with other sexually transmitted infections (STIs), use of tobacco, having multiple sexual partners, unfaithful sexual partners, early sexual activities and immunosuppression due to HIV/AIDS infection puts high the chances of getting this disease,” she said.
“Though cervical cancer does not have specific symptoms, I will encourage our people to come for testing when they experience any of the following signs: vaginal bleeding during or after sex, between periods or after a pelvic exam, vaginal bleeding after menopause, abnormal virginal bleeding or discharge, pain during sex, pelvic pain and backache, and abnormal vaginal discharge that may be watery, bloody or heavy with a foul odour.”
She further explains that most women ignore most of those symptoms because they start as something normal.
Data from Bungoma county health records indicates that it has 421,553 women of reproductive age, of whom 14, 635 have undergone cervical cancer screening with 335 women turning positive. The records further reveal that 156 of the positive cases were treated within Bungoma county hospitals, majorly at Bungoma referral hospital and Webuye county hospital.
The county referral hospital offers both screening and treatment of cervical cancer if detected at an early stage. Currently, Bungoma referral hospital uses The VIA (Visual Inspection with Acetic Acid) as the only screening method.
“We inspect the cervix using acetic acid (distilled vinegar) to identify abnormal changes on the cervix. This method is the most recommended where HPV testing is not available,” Hashora said.
The second method of screening is The HPV DNA Test which detects HPV that can cause pre- cancerous cell changes and cervical cancer. This method helps in identifying women at risk for cervical cancer who may need to be treated to prevent this type of cancer. This method of screening is best recommended for women above 30 years of age.
The third method is the Pap smear ( pap method) which looks for pre-cancer or cell changes on the cervix that can be treated. This method is the primary screening method in women under the age of 30 years and those with an age of above 50 years.
“Early screening that enables treatment and uptake of HPV vaccine are the only ways to stop cervical cancer. Like in the year 2020 we had two women who were identified to be having cervical cancer at an early stage. We took them through cryotherapy (freezing of the pre-cancerous cells) and they were healed. I would also request the county government of Bungoma to make available all the machines required for screening and treatment of cervical cancer,” Hashora said.
Irene Nelima from Kanduyi constituency is one of the first women to be confirmed with cervical cancer at Bungoma referral hospital. Nelima says she was forced to go for screening after experiencing abnormal vaginal discharge that was bloody and with a sharp odour- symptoms of the disease.
She underwent treatment successfully at the facility and is now a cancer survivor. Nelima encourages women to go for routine screening so that they don’t bear the burden of the disease which is often associated with stigma.
“I had been sick for long, a continuous bleeding that was smelling bad. When it was starting I thought it was a sign of menopause but it later worsened with back pains. I came for screening after listening to an announcement on radio about free cancer and fistula testing at Webuye county hospital,” said Gladys Nekoye, who was diagnosed with cervical cancer in 2018.
After the screening which showed she had the disease, a sample from the affected cervix area was taken and pap smear testing done at the She said the screening confirmed that she had the disease and a pap smear test done at the Moi Teaching and Referral Hospital (MTRH).
She commenced treatment two weeks later and the uterus and the left ovary was removed through surgery. She also underwent six chemotherapies and about eight radio therapies among other treatments.
Though COVID-19 which broke out in 2020 disrupted her last clinic appointment at Kenyatta National hospital in Nairobi, Nekoye says she is now well and is not experiencing any more pains unlike before.