September 27

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John and Dayna in Uganda – Cervical Cancer Screening and Treatment

Living in the U.S., we take a lot of things for granted, one of which is that most women will have access to cervical cancer screenings and treatment. The good news is that deaths from cervical cancers in the U.S. are now rare, a success story over the last 80 years. The U.S. Preventive Services Task Force (USPSTF) strongly recommends cervical cancer screening in sexually active American women from age 21 to 65 every three years if the most recent screening was negative.

So, what about the rest of the world? Turns out that with some quick internet searching the statistics are plain to see: world-wide, a woman dies of cervical cancer every two minutes, and 80% of these deaths occur in the developing world. We further learned that less than 5% of women in developing countries are screened, and the burden of the disease there is therefore enormous.

And what about here in Uganda? According to data from Ugandan Ministry of Health, cervical cancer is one of the two most common causes of cancer related deaths in Uganda (sad since this is a disease which is both preventable and curable if detected early). Since there are minimal symptoms until the later stages, screening is imperative. Many women surmise that symptoms of the disease – such as bleeding in between menstrual periods – are normal occurrences.

Though Uganda launched a strategic plan for cervical cancer prevention and control in 2010, today Ugandan women still face a lack of accessible screening locations and functioning treatment centers. It turns out that 11% of deaths in the maternity ward are the result of cervical cancer.

To help address this problem, an increasing number of teenage girls and women in Uganda are now undergoing screening and vaccination to prevent cervical cancer and hopefully receive treatment if required. The good news: we read about how a common household product – vinegar – is helping to make this possible! Visual inspection with Ascetic (ViA) is a screening technology that uses acetic acid (vinegar) to check for cervical cancer. Cost effective, readily available and easy to use in resource-poor settings, this screening technology has the potential to save lives.

For women who test positive, the majority can be treated with cryotherapy, a relatively simple freezing procedure that can be performed on an outpatient basis.

We also learned that the Uganda Women’s Health Initiative (UWHI) is spearheading this initiative. UWHI is a partnership involving the Ministry of Health, Marie Stopes Uganda, Program for Accessible Health, Communication and Education (PACE) and Reproductive Health Uganda with support from the Bill and Melinda Gates Foundation. The UWHI has already set up and runs two cervical cancer screening centers in Kampala which are recognized centers of excellence in cervical screening in Uganda. UWHI also conducts cervical cancer screening around the country.

Still, there is much work to do to penetrate all areas of healthcare. With approximately 17 million females in Uganda, this initiative is just scratching the surface.

Hopefully with Uganda will continue to make strides in diagnosing cervical cancer early.