Cervical Cancer Awareness Month: saving lives can be simple and inexpensive
Global health and economic development challenges do not have many solutions that can be described as “simple” and “inexpensive,” but preventing cervical cancer is both of those things. This January, which is Cervical Cancer Awareness Month, Pink Ribbon Red Ribbon is spreading the word that programs to prevent cervical cancer are a true best buy, and more attention and investment would yield immediate and far-reaching gains for women in low-resource settings.
With the support of in-country policymakers and community representatives, our activities begin with educating communities about cervical cancer, and then mobilizing women to advocate for access to prevention, diagnosis, treatment, care and support. In many places, we build on the infrastructure, training and referral networks already established by the our partner the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), reflecting the close links between HIV, cervical cancer, and human papillomavirus (HPV, the virus that causes most cases of cervical cancer).
HPV is the most common viral infection of the reproductive tract, infecting most unvaccinated sexually active men and women at some point in their lifetime, usually without symptoms. Most people’s bodies overcome the HPV infection spontaneously, but in some people, the infection does not clear, and cervical cancer begins when HPV causes women’s normal cervical cells to develop pre-cancerous changes.
To prevent cervical cancer in adulthood, Pink Ribbon Red Ribbon offers pre-adolescent girls the HPV vaccination. HPV vaccines are highly effective, and can prevent up to 90 percent of cervical cancers. They are also inexpensive: Gavi’s price for a complete, two-dose vaccine vaccination is only about $9. Pink Ribbon Red Ribbon and our partners support country-led vaccination campaigns with vaccine donations, programmatic expertise for roll-out and implementation, and resources for community education and outreach.
For women who have HPV and whose HPV infections do not clear, researchers estimate it can take 10 to 15 years for cancer to develop post-infection. For women between 30 and 49 years of age (25-49 in Zambia), guided by country policies and with the support of the government, we provide screening for cervical cancer, particularly for women living with HIV. Pink Ribbon Red Ribbon’s partners implement the simple, inexpensive cervical pre-cancer “See-and-Treat” screening approach, whose direct medical costs can be less than $25 per woman in low-resource settings. “See-and-treat” involves visual inspection of the cervix with vinegar (acetic acid) to detect pre-cancerous lesions, followed soon or immediately afterward, when necessary, by ablative or electrosurgical (LEEP) treatment, as dictated by the woman’s needs. With early detection, pre-cancerous cells can be removed before they progress to cervical cancer. We are also helping test new molecular diagnostic technologies that will help focus resources on women at highest risk of developing cancer.
As a result of our partner-supported cervical cancer programming since 2011, 119,192 girls have been protected from cervical cancer with the HPV vaccination, 341,863 women have been screened for cervical cancer, and 24,478 women have been treated for cervical cancer or pre-cancer. The lives saved from cervical cancer translate to stronger families and communities, and stronger, more stable economies in low- and middle-income countries.
We are proud that the governments in the countries where we work have used our activities as a base on which to build stronger programs to address cervical cancer. An investment of $3.5 million in financing from PEPFAR will support the transition of the Zambian cervical cancer program to the Ministry of Health by 2019, for example; and the success of Pink Ribbon Red Ribbon-supported HPV vaccination demonstration projects led the Botswana government to accelerate a country-funded nationwide rollout of the vaccine.
In January and beyond, help us tell the positive story of fighting cervical cancer. A simple and inexpensive commitment on the part of the global health community to scaling up prevention and treatment activities could prevent the 236,000 annual deaths from cervical cancer.
By Jennie Aylward, Pink Ribbon Red Ribbon Consultant