With over 12,075 women in Nigeria being diagnosed with cervical cancer and 7,968 dying from the disease annually, January, Cervical Cancer Awareness Month, presents an ideal chance for us to raise awareness for the disease and how it can be prevented through a Pap Smear— a cervical cancer screening used to find precancerous cell changes on the cervix that may develop into cervical cancer if not treated properly— as well as other methods.
Cervical cancer ranks as the 2nd most frequent disease among women in Nigeria, yet, many women have no clue that it is highly preventable and highly curable when detected early. We believe that if more women are made aware of the disease and how to prevent it, we could prevent numerous deaths.
Cervical cancer originates in a woman’s cervix, the passage between the vagina and the uterus. The primary cause of cervical cancer is infection with high-risk human papillomaviruses (HPV), transmitted through sexual contact. Persistent HPV infection can lead to cervical cancer, accounting for 99% of cases.
Early detection and management significantly improve treatment outcomes, making cervical cancer one of the most successfully treatable cancers. Even at later stages, appropriate treatment and palliative care can help control the disease.
Symptoms of Cervical Cancer
At its onset, cervical cancer normally doesn’t have signs and symptoms, making it difficult to detect. The symptoms usually appear after the cancer has spread. Notably, many cervical cancer symptoms are also seen in other less serious conditions, yet there are warning signs you must not ignore. Symptoms of early-stage cervical cancer may include:
- Vaginal bleeding after sex, after menopause or between periods
- Periods that are heavier or longer than normal
- Vaginal discharge that is watery and has a strong odour or that contains blood
- Pelvic pain or pain during sex
Symptoms of advanced cervical cancer may include:
- Constant exhaustion
- Pain in abdomen
- Swelling of the legs
- Difficult or painful urination or blood in the urine
- Difficult or painful bowel movements or bleeding from the rectum when having a bowel movement
- Vaginal discharge that is watery and has a strong odour or that contains blood
Causes of Cervical Cancer
Cervical Cancer is caused by a long-lasting (persistent) infection with HPV (Human Papilloma Virus).
More than half of the general population who are sexually active will become infected with HPV at some point in their lives. In most cases, the immune system effectively manages and clears HPV infections within a year or two, such short-term infections pose no risk of developing into cancer.
However, when a high-risk HPV infection persists for years, it can lead to changes in the cervical cells, resulting in a precancerous lesion. Without the detection and removal of such lesions, there is a risk that it may progress to cervical cancer over time.
People at Risk of Cervical Cancer
Women who become sexually active at a young age, especially before age 18, or have multiple sexual partners are more likely to become infected with a high-risk type of HPV. You are also more likely to have cervical cancer if you:
- Are obese
- Smoke
- Use oral contraceptives
- Have a history of precancerous, or cancerous lesions
However, Cervical Cancer is highly preventable and highly curable if discovered early. It can be prevented through a routine Pap Smear or any alternative cervical cancer screening, appropriate follow-up treatment, and the Human Papilloma Virus Vaccine.
What is a Pap Smear?
A Pap Smear is a routine procedure to test for cervical cancer in women. It involves a healthcare provider inserting appropriate small-sized tools into your vagina, to collect cells from the cervix.
The significance of a regular Pap Smear cannot be overemphasized. It helps prevent cervical cancer by discovering abnormal cervical cell changes in your body that may develop into cancer if left untreated. In situations where one already has cervical cancer, a Pap Smear helps in early detection of the cancer before symptoms begin to arise and more importantly, before it spreads and becomes harder to treat.
How is the Pap Smear Procedure Performed?
During the screening, you will lie on your back on an examination table with your legs open and your feet resting in support. Your doctor will gradually insert a device called a speculum into your vagina. This device keeps the vaginal walls open and provides access to the cervix. Your doctor will then scrape a small sample of cells from your cervix, using either a spatula or brush.
The sample of cells from your cervix will be preserved and sent to a lab to be tested for the presence of abnormal cells.
What is the Duration of the Procedure?
The procedure is very quick, about 10-20 minutes.
Are Pap Smears painful?
While experiences may vary, usually, the Pap Smear is only mildly uncomfortable and does not cause any long-term pain.
Who Needs a Pap Smear?
If you have not had any sexual intercourse, you likely don’t have HPV and don’t have a need for a Pap Smear, but since other types of sexual contact (e.g. kissing, genital contact) can spread HPV, you can’t completely rule out the possibility of being infected with the virus.
Generally, a Pap Smear is recommended to women aged 21 to 29, once every 3 years, regardless of their sexual activity. Although, the frequency of the screening can vary based on your age and health history.
Women older than 29 are usually advised to consult their doctor as often as they need to get a pap smear done.
How Else Can I Protect Myself From Cervical Cancer?
The HPV Vaccine is an essential way to help protect against the HPV infections that lead to cervical cancer. An astounding study published in 2024 showed that no cervical cancer case was detected in women who were fully vaccinated against HPV. However, the HPV Vaccine does not protect against all HPV types that can cause cervical cancer, hence, getting screened at regular intervals is still very important.
The HPV vaccine offers the best protection when administered to someone before they are sexually active. So, sexually active women may benefit less from the vaccination because they may already be exposed to some HPV strains that the vaccine targets.
The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccination for children aged 11 to 12 years old, with the option to start as early as 9. Women aged 26 and below, who missed the vaccination during this period are also suitable candidates for the vaccination. If you are older, you are advised to consult your healthcare provider to assess your suitability for the HPV vaccination.
Condoms, which prevent some sexually transmitted diseases, can also reduce the risk of HPV transmission. However, they do not wholly prevent it. Hence, exposure to HPV is still likely in areas that are not covered by condoms.
Where in Nigeria Can I get a Pap Smear and The HPV Vaccine?
As of September 2024, the National Primary Health Care Development introduced the HPV vaccine into the routine immunization schedule for girls aged 9-14. This means that the vaccine is readily available (for free) at most public health facilities in Nigeria.
Some other private healthcare centres that offer the Pap Smear test and the HPV Vaccine are:
- Marie Stopes (Lagos, Benin, Abuja)
- Planned Parenthood Federation of Nigeria (Abuja)
- Vine Branch Medical Centre, Ibadan.
- Babcock University Teaching Hospital.
- Lakeshore Cancer Center, Lagos.
Join us in the fight against Cervical Cancer by sharing this article with other women!
