Nigeria: New Guidelines to Prevent, Screen, Treat Cervical Cancer

Nurse Rehema Nkomola examines a woman for cervical cancer. Global deaths from cervical cancer have increased 40% since 1990, to 266,000 (file photo).

The Society of Gynaecology & Obstetrics of Nigeria (SOGON) has launched the first-ever national guidelines for screening and detection of cervical cancer.

The guidelines limit screening to only women aged between 25 and 65 and pregnant women.

Cervical cancer occurs when the cells of the cervix at the neck of the womb grow abnormally and invade other tissues and organs.

It is caused by the human papilloma virus but progresses slowly, sometimes taking up to 20 years. The virus is found in 97 out of 100 people with cervical cancer-and testing for it can help patients and medical workers know whether to follow up or not.

Limiting age of screening to 25 eliminates lots of unnecessary testing for women of lower ages. Above 25 years, the screening will look for precancerous lesions which can be cut off or destroyed. Most women who are eventually diagnosed with cervical cancer are in the mid-50s but the guidelines extend screening up to 65 years.

"This is one step to take," said SOGON president Oluwarotimi Akinola at the launch of the guidelines in Abuja.

"Now we have a weapon, we want to leapfrog and catch up with the developing world, because they have been able to tame this disease.

Evidence considered by expert gynaecologists and obstetricians also support screening for cervical cancer in pregnancy, according to the guidelines.

"In our environment, that is topical. That is probably the only time a lot of women access hospital. If we are trying to reduce maternal mortality by bringing [women] to deliver [in hospital], we also can add this on and make sure when they pass the age of delivery, they don't die from cervical cancer," said Akinola.

The guidelines, expected to influence training of health workers, will also remove confusion about what cervical cancer guidelines medical students are taught or assessed by.

It is the first time Nigeria will use a country-specific guidelines in dealing with cervical cancer. Up until now, it has borrow guidelines from the US, UK and even Australia.

Lots of nongovernment groups run cervical cancer screenings on women of all ages.

Joseph Onah, programme manager for the Cancer Plan, says the guidelines now offer scientific evidence.

"More than 50% of people who test positive don't ever get to hospital. If you do a test and don't get to hospital, you just get the woman in anxiety," he notes.

Cervical cancer kills one woman every two minutes-eight in 10 of them in the world's poorest countries. It kills one woman every 10 minutes in Africa-and is the second most common type in Nigeria after breast cancer.

The vaccine HPV is known to prevent cervical and is listed as preventive measure in the guidelines.

It is yet to be introduced into vaccination schedule but is part of support extended by the Global Alliance for Vaccine Initiative.

As yet only private care centres offer it, prominently in Oyo and Lagos.

It expected each geopolitical zone will have at least one centre by year end, and then double by 2019, according to Taofik Oloruko-Oba, country head of Roche Diagnostics at Roche Nigeria.

Gynaecologist Idris Wada says setting up satellite centres can help experts reach women in remote locations.

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