Carcinoma Of The Uterine Cervix In Nigerian Women: The Need to Adopt a National Prevention Strategy.

Abstract

Background: Cervical cancer is the second most common type of cancer affecting women, and was responsible for over 250,000 deaths in 2005, approximately 80% of which occurred in developing countries. Without urgent action, deaths due to cervical cancer are projected to rise by almost 25% over the next 10 years. Prevention of these deaths will contribute to the achievement of the Millennium Development Goals. In Nigeria, carcinoma of the cervix is the commonest malignancy of the female genital tract, with an estimated incidence of 32 per 100,000 females. As a result of extremely poor knowledge and attitude towards cervical screening, and limitations posed by lack of facilities and human resources for its control, many women are presenting with, and dying from, complications of advanced stages of this preventable disease. Unfortunately, there are only five major functional radiotherapy facilities in Nigeria at present culminating in very long waiting queues for treatment. Consequently, many women never benefit from treatment before they die in despair. The subject of this review is to explore how this situation can be reversed.
Objective: To determine the magnitude of, and social factors associated with, cervical cancer in Nigeria and the efforts being made to reduce the disease burden in Nigerian women. To proffer cost-effective strategies for intervention.
Method: The review of previous strategies employed in targeted, hospital-based cervical screening programs in Nigeria and literature search in Medline, PubMed and Google.
Results: There is poor public awareness of cervical cancer and strategies for its prevention. The utilization of hospital-based prevention programs (cervical screening) is extremely poor leading to a minute percentage of the population at-risk being reached. Many women present with advanced stages of the disease that require radiotherapy, which many can neither access nor afford.
Conclusion: The number of Nigerian women with unmet need for cervical cancer screening is large. We recommend the augmentation of current prevention strategies with three pragmatic models viz the “Hub and Spoke Model”, the “Mobile Van Cervical Cytology Clinic (MV3C) Model” and the “Screen and Treat Model” to reach the larger rural population who are the predominant victims of this disease.


Keywords: Cervical cancer, Prevention, ‘Hub and Spoke', Mobile Clinic, Screen and Treat, Model, Nigeria

Sahel Medical Journal Vol. 11 (1) 2008: pp. 1-11