ZAMBIA: Cervical cancer screening saves lives
JOHANNESBURG, 18 February 2010 (IRIN) - Cervical cancer is a leading killer among women living with HIV, but a low-cost screening programme developed in Zambia is proving that simple techniques can go a long way in saving lives.
presented this week at the 17th Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco has shown that cervical cancer screening among HIV-positive women prevented one death for every 32 women screened.
Presented by Dr Groesbeck Parham of the University of Alabama at Birmingham, the research originated from a pilot study of about 6,600 HIV-positive women examined as part of the Cervical Cancer Prevention Programme in Zambia
(CCPPZ), an ongoing low-cost screening project. More than half the women had abnormal results, and about 20 percent were diagnosed as having lesions at varying stages from pre-cancerous to advanced cancer.
According to the World Health Organisation, cervical cancer
- which is caused by the human papilloma virus (HPV) - is the second biggest cause of female cancer mortality worldwide.
It is thought that women living with HIV are at a higher risk
of cervical cancer, but the number of women being screened for the cancer remains low, especially in developing countries.
Results raising awareness
|In Zambia, cervical cancer is the biggest gynaecological burden we have, and the numbers of doctors that are equipped to handle it are few.
Dr Mulundi Mwanahamuntu, CCPPZ co-director alongside Parham, said screening was virtually nonexistent before the programme was set up.
"The [cancer] was still found, but usually at a stage where it was untreatable," he told IRIN/PlusNews. "In Zambia, cervical cancer is the biggest gynaecological burden we have, and the numbers of doctors that are equipped to handle it are few."
He said the programme had helped propel cervical cancer onto the national health agenda, and had prompted high-level discussion about the possible introduction of the HPV vaccine
in the public health sector.
Screening by the programme's service costs about US$1 as compared to pap smears that cost about $15 and remain prohibitively expensive even in richer countries like South Africa
. To keep costs this low, the programme enables health workers and nurses to carry out screening and treatment, allowing doctors - already in short supply - to perform other tasks.
The technique has been implemented nationally by training staff members at organizations like the Marie Stopes clinics for women's health, and the Zambian armed forces. The screening programme has also drawn interest from other countries, including Botswana, Tanzania and Cameroon, which have sent delegations for training.
The benefit of early cervical cancer screening seems to be undeniable, but Mwanahamuntu said questions remained as to how the cancer progressed in HIV-positive women, and how women at different clinical stages of HIV reacted to treatment for cervical cancer.