Fact: Across the world, breast cancer kills more women than any other cancer.
Fact: In Ghana, more women die of cervical cancer than breast cancer every year.
Fact: 99.7% of cervical cancer cases are caused by the Human Papiloma Virus (HPV).
Fact: It takes between 8 and 12 years for this virus to infect cells and lead to a carcinoma (and, therefore, cancer of the cervix).
So in 2010, why were 79,000 Ghanaian women diagnosed with a cancer that takes a decade to develop? And why did 62,000 of these women lose their lives?
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About 80% of all women will have the HPV virus in their lifetime. In some cases, an individual's own immune system will lead to spontaneous regression, preventing the development of cervical cancer. However, in most cases, the virus will live within the cells of the cervix (therefore, preventing immune response) and trigger cell division to the extent of the formation of a carcinoma. Since the cancer takes so long to develop, interval screenings are used to detect the presence/ absence of HPV. If a woman comes back HPV positive, there's usually plenty of time to treat her before a cancer develops.
In the UK, we whine and complain when our GP writes to us remind us about appointments and check ups and boosters and vaccinations, and most women "just don't have the time" to get a smear test.
But in Ghana, no one writes to you.
Women have to register for smear tests themselves and pay 40GHC (about £15). But only the women who have been educated in the benefits of smear tests will seek this treatment and even those in the know may not be able to afford the procedure so many of us take for granted.
There is an HPV vaccine (2008) used to immunise young women (which is administered to 12/13 year olds in the UK with a catch up mass immunisation of girls up to the age of 18) which is completely free on the NHS in the UK. In Ghana, however, the complete vaccine costs 210GHC (about £80).
Even if the majority of women across Ghana were screened regularly, there are only 20 active cytologists in the country, therefore, a backlog of cases would be inevitable.
Despite all these barriers, the team at the Reproductive Health Centre at Korle Bu Teaching Hospital, are finding ways to promote the risk factors associated with contracting HPV as well as educating women in the importance of screening every few years. The team are looking to start work with Healthcare Officers in CHP Zones (Community based Health Planning) i.e. in rural areas and remote villages in order to educate women there and carry out simple smear procedures in pop-up clinics. Since there is no nationwide programme so far, these community based systems would be the best way to reach the masses.
This is not the part where I direct your attention to a charity about cervical cancer awareness, nor do I want us to try and sympathise with the women across the world who aren't even aware that this cancer can be so easily avoided.
I simply want to applaud the work of the nurses and counsellors at Korle Bu Teaching Hospital who continue to work hard to reach out to the women of Ghana, and, most importantly, to remind us to be thankful for what we often take for granted.
