WeeklySA_AdminDeath: Local women disproportionately affected by the disease with 11000 new cases reported annually.
By Monk Nkomo
Thousands of South African women living with HIV, mostly those who are middle-aged, face three times a higher risk of developing cervical cancer than those without the virus.
This is according to researchers from the University of Cape Town and the University of Bern in Switzerland in a report released on Wednesday . The research, published in the International Journal of Cancer, also established that the biggest relative impact of HIV on cervical cancer risk was among young women, but in absolute terms, middle-aged women bore the highest cervical cancer burden.
Around 8.45 million people in South Africa live with HIV – an estimated 13.9% of the population. Of South African women aged 15-49, approximately 24% are HIV positive. Cervical cancer is the second most common cancer among South African women, but the type women die of most in this country, according to the Cancer Association of South Africa, which adds that women in South Africa have a 1 in 42 lifetime risk of cervical cancer. Researchers from both universities assessed cervical precancer and cervical cancer incidence among more than 500 000 women with and without HIV having used reimbursement claims data from a private medical insurance scheme in South Africa between January 2011 and June 2020. ‘’ Of the 517 312 women, 564 developed cervical cancer’’.
Cervical cancer has been described as the fourth most common cancer among women worldwide, but women in Sub-Saharan Africa were disproportionately affected by this disease. Cervical cancer was the second most common cancer with nearly 11 000 new cases reported every year and being the most frequent cause of cancer-related deaths among women.
The team of researchers found that cervical cancer risk was highest in older women of between ages 65 and above whereas cervical precancer most commonly occurred among women in the mid-20s to mid-40s. Other risk factors for cervical precancer and cervical cancer included a history of genital warts and other sexually transmitted infections. ‘’ The results underscore the significance of early detection and treatment of cervical lesions in preventing cervical cancer especially among women with HIV’’, said Dr. Eliane Rohner, co-author of the study and Head of the Cancer research group at the University of Bern.
‘’ To effectively fight cervical cancer in South Africa and other countries where both HIV and cervical cancer are a big problem, it is crucial to study how cervical precancer and cervical cancer rates vary by age and HIV status. This information will help us create better and more focused strategies for preventing cervical cancer.’’The co-author of this research and Head of the Division of Clinical Pharmacology at the University of Cape Town, Professor. Gary Maartens, said more frequent cervical cancer screenings were recommended for women with HIV.
Key facts from the World Health Organization about cervical cancer are:
- Cervical cancer is the fourth most common cancer among women globally, with an estimated 604 000 new cases and 342 000 deaths in 2020. About 90% of the new cases and deaths worldwide in 2020 occurred in low- and middle-income countries (1).
- Two human papillomavirus (HPV) types (16 and 18) are responsible for nearly 50% of high grade cervical pre-cancers
- HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. More than 90% of them clear the infection eventually.
- Women living with human immunodeficiency virus (HIV) are 6 times more likely to develop cervical cancer compared to women without HIV.
- Vaccination against HPV and screening and treatment of pre-cancer lesions is a cost-effective way to prevent cervical cancer.
- Cervical cancer can be cured if diagnosed at an early stage and treated promptly.
- Comprehensive cervical cancer control includes primary prevention (vaccination against HPV), secondary prevention (screening and treatment of pre-cancerous lesions), tertiary prevention (diagnosis and treatment of invasive cervical cancer) and palliative care.
Other factors that contribute to cervical cancer are obesity, inactivity, alcohol consumption, poor dietary habits, smoking and exposure to chemicals.
