hato Chwaane
14 January 2008
Cervical cancer is the commonest cancer killer of women in this country, an obstetrician and gynaecologist has said.
Speaking to Monitor on Friday, Dr Doreen Ramogola-Masire, who is in charge of women's health at the Botswana-UPenn (University of Pennsylvania) Partnership, said this cancer develops on the 'mouth' of the womb called the cervix and is fairly rare in developed countries due to their well-organised national cervical cancer prevention programmes. Ramogola-Masire said due to insufficient healthcare delivery systems, limitations in resource allocation, shortage of manpower, competing health needs and an uninformed public, many women die of this preventable disease in most developing countries. This cancer kills twice as many women than breast cancer and is known as the silent killer. The disease takes long to develop, often starting with minor changes on the skin covering the cervix.
The changes can be detected by doing a simple test of a Pap Smear. "If not detected at this stage and treated appropriately, some of them can progress to cancer over many years," Ramogola-Masire warned. By the time a woman develops symptoms such as abnormal bleeding, the cancer is at an advanced stage, making treatment and cure very difficult. The majority of such women die in five years.The majority of women with cervical cancer have never had a Pap Smear in their lifetime, or they have had a Pap Smear but never went back for results for whatever reason, or the Pap Smears have been incorrectly read. Ramogola-Masire said sometimes women with cervical cancer are those with abnormal Pap Smear who did not access care, or were inappropriately managed or women living with HIV.
Women living with HIV are believed to be three to four times more at risk to develop cervical cancer than HIV negative women. Hence, it is imperative for this risk population to have regular access to regular screening. There is need for skilled and dedicated health care workers, adequate care facilities, availability of screening and coordinated efforts in communicating and educating the public. Ramogola-Masire said there should be political will and advocacy by civil society to prioritise this issue. Meanwhile, after several consultations, the Botswana Network on Ethics Law and HIV and AIDS (BONELA) has found that 70 percent of women living with HIV were not aware of Pap Smears. This is despite the fact that women living with HIV are at a greater risk of developing cervical cancer because HIV has suppressed their immune system.
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