This January alone, as Nigeria joins the rest of the world to mark the cervical cancer awareness month, no fewer than 805 Nigerian women would die from cervical cancer, going by the data from the Cervical Cancer Free Coalition.
From the data, 14,550 cases are diagnosed in women of 15 to 44 years of age annually in Nigeria with as many as 9,659 of the cases dying from the disease. But these deaths, according to experts, could have been prevented, since cervical cancer is the easiest of all cancers to prevent. Its causative agent, which is Human Papilloma Virus is also known and it is responsible for causing 100 per cent of cervical cancer cases, a Radiologist, Prof. Ifeoma Okoye, disclosed.
“Human papillomavirus is the root cause of more than 5 per cent of cancers, including nearly all cervical cancers and a substantial percentage of cancers at other sites such as vagina, vulva (the outer or external part of the female genital organs), penis, scrotum, perineum, anus, head/neck, mouth, throat, nose, tonsil, skin, nail-bed, and conjunctiva (eye)”, she said.
The disease can be prevented primarily through HPV vaccination for those not sexually exposed and those who test negative for HPV DNA, she further said. However, for those already sexually active, Dr Abia Nzelu Executive Secretary, Committee Encouraging Corporate Philantropy (CECP), explained that regular annual PAP smear screening or Visual Inspection through Acetic acid, VIA, testing, could prevent the disease.
“Cervical screening is the best cancer screening test in the history of medicine and most cost effective of all medical screening tests. The screening is painless and takes only about 5 minutes to perform. The tissue changes that lead to cervical cancer usually develop very slowly (over a period of about five to thirty years). Screening can find these changes before cancer develops. Pre-cancer changes are easy to treat by outpatient procedure lasting 15 minutes”, she said.
Furthermore, Dr. Nzelu, explained that there is now a vaccine – Gardasil which prevents most cases of cervical cancer, warts, Recurrent Respiratory Papillomatosis (RRP) and a proportion of other HPV cancers.
Unfortunately, as a result of lack of awareness, low socioeconomic status and poor health care seeking attitude, cervical cancer has continued to kill Nigerian women yearly.
According to the CECP, most women are not aware of the need for cervical cancer screening and most have never heard about cervical cancer screening in their lifetime. As a result, cervical cancer continues to kill about one woman every hour in Nigeria.
“The rural Nigerian woman is worse off, because of the absence of adequate medical facilities for screening, diagnosis & follow-up. Cervical cancer is the commonest cause of cancer-related death in women in parts of Nigeria. A strong risk factor for cervical cancer is early age at first sexual intercourse and first childbirth. The practice of child marriage in parts of the country therefore contributes to a higher incidence of cervical cancer”.
To prevent cervical cancer from killing more women in Nigeria, Dr. Femi Olaleye, the founder of Optimal Cancer care foundation advocates that pre-sexually active teenagers should be provided with free vaccines.
Although the cost of the HPV vaccine given to girls and women to prevent the cancer which was formerly pegged at about N20, 800 has been reduced to about N15, 000, many Nigerian women still cannot afford to pay to get vaccinated. Although Nigeria had for some time enjoyed vaccine subsidy support from GAVI Alliance – a global Vaccine Alliance, which helps to provide access to new and underused vaccines for children living in the world’s poorest countries, the country will have to rely on her resources alone to be able to immunise Nigerian girls against the Papilloma virus.
According to Dr. Seth Berkley GAVI’s CEO Nigeria would be excluded from benefiting from the globally subsided vaccines due to poor vaccination system and poor coverage. “The immunisation coverage in Nigeria is just above 40 per cent. For this programme to be effective, we are only giving it to countries that have demonstrated that they have the capacity, infrastructure and human resources to get the HPV vaccines administered effectively.
“We are not giving it to countries where we can see that their cold chain storage system is not effective and vaccines cannot be stored appropriately or where vaccines would not get to the end users because they do not have the human resources or facilities. Nigeria has not met these criteria,” Berkley was quoted to have said in a media report.
Although denied of the privilege, this is not to say that Nigeria as a country cannot make provision for subsidized vaccines for its women without support from international organisation.
“Government is not taking vaccination for cervical cancer serious because they are thinking of how much money it will cost them. The reason why they think it is a lot of money is because nobody is counting the cost of the women that are dying. If the cost of women that are dying daily in this country is counted and government can see it as a loss, then they can now see the need to pay attention to prevention.
“The vaccine is about N4-5, 000 per dose which is about N15, 000 per person. But the cost of a woman’s death from cervical cancer is probably more than 15, 000 naira to the society and the whole country. The vaccination can be spread over a 10 year period; it is not something you do at once. You can vaccinate only 16 years old in a particular year, and take another age group in another year. The fund remains the same and everybody will be covered,” Dr Olaleye stated.