...At your Cervix!

This post is not about the actual diagnosis of cervical cancer, it is about reducing our risk!

Nigeria has a population of 50.33 million women ages 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 14089 women are diagnosed with cervical cancer and 8240 die from it. This is huge!

Cervical cancer ranks as the 2nd most frequent cancer among women in Nigeria and the 2nd most frequent cancer among women between 15 and 44 years of age. About 3.5% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 66.9% of invasive cervical cancers are attributed to HPVs 16 or 18.(hpvcentre.net).

Data from different studies in Nigeria show that many women do not view cervical cancer as a a common disease and a lot of women view pap smears as only for the elite.

Cervical cancer is on the rise but the screening uptake remains suboptimal. This is sad given that it is a highly preventable and curable disease when detected and treated early.

Factors that increase the risk of cervical cancer include:

• Human papillomavirus (HPV) infection: This is the most important risk factor for cervical cancer. Research shows that infection with this virus is a risk factor for cervical cancer. Sexual activity with someone who has HPV is the most common way someone gets HPV and there are over 100 different types of HPV, not all of which are linked to cancer. The HPV types that are most frequently associated with cervical cancer are HPV16 and HPV18.
• Immune system deficiency: Women with lowered immune systems have a higher risk of developing cervical cancer. A lowered immune system can be caused by immune suppression from  medications, organ transplantation, treatments for other types of cancer, or from HIV which is the virus that causes acquired immune deficiency syndrome (AIDS). When a woman has HIV, her immune system is less able to fight off infections including early cancer.

  

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• Herpes:Women who have genital herpes have a higher risk of developing cervical cancer.
• Smoking:Women who smoke are about twice as likely to develop cervical cancer compared to women who do not smoke.
• Age. Girls younger than 15 years old rarely develop cervical cancer. However the  risk goes up between the late teens and mid-30s. Women over 40 years of age remain at risk and need to continue having regular cervical cancer screenings, which include both a Smear test and HPV test of previously HPV free.
• Socioeconomic factors:Cervical cancer is more common among groups of women who are less likely to have access to screening for cervical cancer which sadly is a  lot of women in Nigeria.
• Oral contraceptives:Some research studies suggest that oral contraceptives may be associated with an increase in the risk of cervical cancer. However, more research is needed to understand how oral contraceptive use and the development of cervical cancer are connected.
  Prevention and Screening
  Cervical cancer can often be prevented by having regular screenings to find any precancerous changes and treat them. Modifying certain factors is also important.
  • Delaying first sexual intercourse until the late teens or older.
  • Limiting the number of sex partners
  • Avoiding sexual intercourse with people who have had many partners
  • Avoiding sexual intercourse with people who are obviously infected with genital warts or show other symptoms
  • Quitting smoking
  The HPV vaccine helps prevent cervical cancer caused by HPV. Gardasil is a vaccine that is quite readily available  and it works by preventing infection from HPV-16, HPV-18, and 5 other types of HPV linked with cancer. There were 2 other vaccines but I won’t delve too much into this. If you have had the HPV Vaccine, you are protected against at least 70% of cancer causing HPV infections but not fully protected.This is the reason I would like to stress the absolute importance of smear tests to detect changes caused by Other HPV strains.To help reduce our risk and prevent cervical cancer, WHO reccommends that girls receive HPV vaccination . However I will reccommend scheduling an appointment with a trained medical practitioner to discuss an appropriate schedule of vaccination.
  Screening is used to look for cancer or abnormalities that may become cancerous before you have any symptoms or signs. 
  The following tests and procedures could potentially be used to screen for cervical cancer:
  • Bimanual pelvic exam: In this examination, the doctor will check a woman’s body for any unusual changes in her cervix, uterus, vagina, ovaries, and other nearby organs. To start, the doctor will look for any changes to the woman’s vulva outside the body and then, using an instrument called a speculum to keep the vaginal walls open, the doctor will look inside the woman’s body. Some of the nearby organs are not visible during this exam, so the doctor will then insert 2 fingers of 1 hand inside the patient’s vagina while the other hand gently presses on the lower abdomen to feel the uterus and ovaries. This exam typically takes a few minutes and is done in an examination room at the doctor’s office.
  • HPV test:This test is done on a sample of cells removed from the woman’s cervix, the same sample used for the Pap test (see below). This sample is tested for the strains of HPV most commonly linked to cervical cancer. HPV testing may be done by itself or combined with a Pap test. This test may also be done on a sample of cells collected from a woman’s vagina, which she can collect herself.
  • Pap smear test: The Pap test has been the most common test for early changes in cells that can lead to cervical cancer. This test is also called a Pap smear. A Pap test involves gathering a sample of cells from the cervix. It is often done at the same time as a bimanual pelvic exam. A Pap test may be combined with an HPV test.
  • Visual inspection with acetic acid (VIA): VIA is a screening test that can be done with few tools and the naked eye. During VIA, a dilution of white vinegar is applied to the cervix. The health care provider then looks for abnormalities on the cervix, which will turn white when exposed to vinegar. This screening test is very useful in places where access to medical care is limited.
  ASCO(The American Society of Clinical Oncologists) recommend that all women receive at least 1 HPV test to screen for cervical cancer in their lifetime. Ideally, women 25 to 65 years old should receive screening with the HPV test every 5 years. Women 65 and older may stop screening if their HPV test results have been mostly negative over the previous 15 years. Sometimes, women who are 65 and older and who have tested positive should continue screening until after 70.
  Personally I recommend that young girls in secondary school be offered HPV testing and subsequent vaccination as appropriate because the age for first sexual encounter is gradually on the decline in Nigeria and we need to recognize this. If you are a sexually active woman I recommend strongly that you have the HPV test and regular smear tests. 
  
  I have attached a list of some centres that offer paid and free screening (List is from canceraware.org.ng, a great website). I really hope if you’re reading this that you take steps to attend screening and if you require details for screening centres please comment below, someone might be able to help! 
  Till next week, please share this with someone and take steps to owning your health! 
  
  
  
  
• Lagos
  
  
  Health Kinect Clinic
  1st Floor, Beulah Land Plaza
  BTW 2nd and 3rd Roundabout
  Same building as Vitafoam
  Lekki Expressway, Lekki.
  Screening Test: VIA (Visual Inspection with acetic acid)
  Appointment required: Call 08023039096
  (Mention CancerAware when booking)
  HPV Vaccination and Cryotherapy Treatment available
  .
  Sebeccly Cancer Care 
  NUT House. 29 Commercial Avenue, Sabo, Yaba
  Screening Test: VIA (Visual Inspection with acetic acid)
  Appointment required Call 08170272543 or book online at sebecclycancercare.org/booking (Mention CancerAware when booking)
  Colposcopy and Cryotherapy treatment available
   .
  Qmed Diagnostics                          
  3 Adeniran Ogunsanya Street
  Beside FedEX, Surulere.
  08033002946
  Pap Test
  . 
  Arrive Alive Diagnostics and Imaging
  35 Cole Street off (Same road as Diamond Bank)
  Ojuelegba
  08091838811
  Pap Test (Mention CancerAware when booking)
  Colposcopy available
  .
  Foremost Radiology
  50 Ogunlana Drive, Surulere
  08062392299
  Pap Test
  .
  Lakeshore Cancer Center
  14 Amodu Tijani Close, Victoria Island.
  08034175046
  Liquid Based Cytology 
  HPV vaccination available.
  .
  Optimal Cancer Care
  118 Bode Thomas Street Surulere
  08081076646
  Screening Test: VIA
  Cost: N2500 (Monday to Thursday). Free on Fridays throughout January.
  .
  The Bridge Clinic (MediCentre)
  66 Oduduwa Way, GRA Ikeja
  09068350060
  Liquid Based Cytology
  HPV Vaccination and HPV Testing also available
  .
  Well Woman Clinic
  2nd Floor Surgical Outpatient
  Lagos University Teaching Hospital, (LUTH)
  Idi-Araba, Clinic Hours: 9a.m - 1p.m
  Screening Test: Pap Test
  HPV Vaccination available
  .
  Medicheck
  46 Oduduwa Crescent GRA Ikeja
  08189804994
  Pap Test
  Cost: N10000
  .
  George's Memorial Medical Centre
  6 Rasheed Alaba Williams
  Lekki Phase 1.
  Pap Test/Liquid Based Cytology
  HPV vaccine available.
  08078191607
  .
  Help Diagnostics (Maryland & Ikorodu)
  Behind Mobil Filling Station, Maryland.
  09090146050, 08187151810
  Screening Test: Pap Test
  .
  Clina - Lancet Laboratories
  3 Babatunde Jose off Adetokunbo Ademola, 
  Victoria Island.
  07046181382, 08126342294
  .
  ClearView Hospital
  14B Taiye Olowu street, off Victoria Arobieke street
  Lekki Phase 1, Lagos
  09030000627
  Pap Test/ Liquid Based Cytology: 
  .
  The Specialist Laboratories 
  6, Sodipo St Off Mabo Street
  Surulere
  08025789286
  Screening Tests
  Pap Test and HPV DNA Testing
  .
  Mecure Lekki and Oshodi
  07000632873
  Pap Test
  
  .
  Healthwize Consult
  Opic Estate, Warewa
  Along Lagos Ibadan expressway
  Just before Arepo.
  08023385881
  VIA
  Pap Test
  .
  .
  Abuja
  Firmcare Laboratories
  Suite A3/A4,Tswanya Centre,
  Muhammadu Buhari Way,
  Area 11 Garki Abuja
  08091064763, 08091064748
  January offer: (Mention CancerAware when booking)
  Pap Test
  Liquid Based Cytology
  HPV Testing
  .
  MedicAid Diagnostics
  2, Librevile Street,Off Aminu Kano Crescent,
  Wuse 2, Abuja
  0708744634, 07030044300
  Screening Tests: VIA
  Pap Test
  HPV Vaccination
  .
  Ibadan
  ABC Foundation 
  Block 1 plot 4, Ibadan Municipal Government,
  off Adeoyo State hospital. Ring Road.
  07010368526
  VIA (Visual Inspection with acetic acid)
  HPV testing
  . 
  Family Specialist Hospital, Bashorun, IBADAN
  Pap Test: N7500
  HPV Vaccination
  08097762200, 08097763300
  Screening is done every Saturday while vaccines are available everyday of the week.
  .
  MECURE IBADAN
  5, Awosika Avenue, Old Bodija.
  07066615139
  Pap Test
  .
  Kaduna
  Echo Scan
  4, Katsina Road, by Independence Way.
  08023098373
  Pap Test
  .
  Kano
  MECURE 
  8, Post Office Road (Opposite MoH)
  Kano.
  07088650983
  Pap Test
  .
  Jos
  Meena Histopathology Lab
  Consitution Hill Rd, Close to Christian Pilgrims and Hospital Management board.
  Jos
  08091555722
  Pap Test
  .
  Port-Harcourt
  Hugo Health Systems
  82 Peter Odili Road
  08037908623, 09052339306
  Pap Test
  HPV Testing and Vaccination available
  .
  Benin City
  Echo Scan.
  08055666943
  Pap Test
  .
  Central Hospital Benin
  Pap Test
  .
  University of Benin Teaching Hospital
  Pap Test
  .
  Oghara
  Echo Scan.
  08023342566
  Pap Test
  .
  Umuahia
  Mecure
  Opposite Federal Medical Center,
  Aba – Oweri Road,
  07088646026
  Pap Test
  .
  Federal Medical Centre, Umuahia
  0706 9337998, 0803 8089468
  Pap Test
  .
  Asaba
  ECHO Scan
  Penny Mart Estate
  272/273 Nnebisi Road
  Opp. First Bank, Beside FCMB
  08036185481
  
  Asaba
  Federal Medical Centre, Asaba. 
  Pap Test
  .
  Aba
  Abia State University Teaching Hospital AND 
  Federal Medical Centre, Aba.
  Pap Test 
  .
  Nnewi
  Nnamdi Azikiwe University Teaching Hospital
  Gynaecology Clinic
  Nnewi
  Pap Test
  .
  Enugu
  Breast Without Spot Wellness Centre
  4 Chime Lane
  Abakaliki Road, Opposite State School Board
  Enugu
  08037413332
  .
  Warri
  West End Hospital and Diagnostic Centre
  1, 25TH Street, Westend Hospital Road,
  D.D.P.A., Off Airport Road, Ugborikoko,
  Effurun, Warri.
  08025374579
  Pap Test
  . 
  Kwara
  Leah Foundation HQ
  Abdulkareem Adisa,GRA,
  Ilorin
  09080066337
  VIA
  Cryotherapy, Colposcopy and HPV Vaccination available
  .
  Abeokuta
  Federal Medical Centre
  Olabisi Onabanjo Way,
  Idi-Aba
  Abeokuta.
  08095948007 08095947913
  Pap Test
  .
  KAAF Foundation
  IPERU (Near Babcock Uni) OGUN STATE
  KAAF Building.
  Iperu.
  VIA. (Visual Inspection with acetic acid)
  Free every 3rd week of the month.
  Thursday - Saturday
  08132354647.