In the African country of Senegal — population 15.41 million — cervical cancer is the leading cause of cancer deaths among women, and the nation ranks at number 15 in global cervical cancer prevalence. Considering the cancer is completely treatable through early detection, the number of deaths from cervical cancer in Senegal is startling.
Cervical cancer is the third most commonly diagnosed and the second most common cause of cancer deaths among women. However, in the U.S. and other developed countries, cervical cancer does not even rank among the top three cancer killers. Why the discrepancy between nations like the U.S. and developing nations like Senegal?
The answer is simple: access to screenings and vaccines.
Screening for a Treatable Cancer
While cervical cancer was the leading cancer killer of women in the U.S. until the 1950s, development of the Papanicolaou (Pap) smear allowed for detection of cell abnormalities. In the following decades, scientists and doctors learned that cervical cancer is the most preventable and treatable type of cancer because it develops very slowly.
“There are 5 to fifteen years from the first cellular changes to the actual cancer development,” says Dr. Andrew Dykens, professor of family medicine at the University of Illinois at Chicago (UIC). “So you’ve got time during that phase to do something about it.”
Dykens is director of the Global Community Health Track at the Center for Global Health at UIC. He is also a former Peace Corps volunteer and current member of Rotary International (Rotary Club of Chicago). He also started the nonprofit Peace Care, which provides resources by bringing together the local expertise of Peace Corps workers and the communities who need them.
Dykens worked with each of these organizations and Senegal’s Ministry of Health and Social Action to bring low-cost screening to the women of the nation. A method even simpler than a Pap smear, a vinegar solution is used to detect abnormal cells. The cells can be killed off immediately with a cryotherapy gun and a CO2 tank — another simple method that involves no electricity.
The Cancer Vaccine
In 2013, the global vaccine alliance Gavi selected ten African countries for a pilot human papillomavirus (HPV) vaccination program, with Senegal being among them.
Certain strains of HPV are the cause of cervical cancer. While the HPV vaccine has been used in the U.S. and other developed countries since 2006, it was finally introduced to Africa in 2016. Along with Rwanda and Uganda, Senegal is one among the first three countries to adopt the vaccine as part of its national vaccination program.
Professor Ousseynou Badiane, head of Immunization Division for the Ministry of Health in Senegal, states that through subsidization by Gavi and the Senegalese state, the vaccine will be accessed by all at no cost. The vaccine is being implemented in two phases – first, a mass vaccination for girls between age 9 and fifteen by May 2018; after that, it will become part of routine immunizations for all girls at age 9.
In the U.S., women are commonly screened for cervical cancer every three years. For cervical cancer in Senegal, many women are being screened for the first time. Dykens and other health practitioners understand the challenges they face in terms of a traditionally conservative environment concerning women’s health issues. But with Peace Care, local Rotary clubs, Gavi, and others working together with the nation’s government, promotion of awareness and education will reduce the number of deaths caused by cervical cancer in Senegal.
– Jaymie Greenway