Cancer Prevention: Cervical and Breast Cancer

What is the most common cancer in women worldwide? Second most common?

• breast cancer

• cervical cancer

Where do 80% of all cases of cervical cancer occur?

low-income countries (here cervical cancer is the most common cancer in women)

What are virtually all cases of cervical cancer linked to?

genital infection with HPV

What is the primary prevention for cervical cancer? Secondary? Tertiary?

• primary: HPV vaccination

  • target mainly 10-14 year old girls (before they become sexually active)

• secondary: screening via PAP smears, HPV tests, and/or VIA

• tertiary/palliative care: diagnosis and treatment of cervical cancer

What are the 90-70-90 targets?

• targets that must be met by 2030 for countries to be on the path towards cervical cancer elimination

• 90% of girls fully vaccinated with HPV vaccine by age 15

• 70% of women screened with a high-performance test by 35 years and then again by age 45

• 90% of women identified with cervical disease receive treatment

What is the link between cervical cancer and HIV?

HIV infected women who are also infected with HPV are 6 times more susceptible to cervical cancer than HIV-negative women

What is the low-cost screening method for cervical cancer used in low-resource settings?

• visual inspection with acetic acid (VIA) screening

• soak the cervix for about 5 minutes with regular vinegar

What are the advantages of digital cervicography?

• photos can be saved and reviewed by a panel of physicians (getting a second opinion is possible)

• photos can be viewed remotely for real-time physician consultation

What is the recent shift in the WHO’s strategy towards HPV testing?

HPV DNA testing instead of looking at photographs of the cervix because its an objective test and more cost effective

What is cryotherapy?

A treatment method for precancerous cervical lesions that involves freezing abnormal cells using a cryoprobe, resulting in cell destruction

How long does the HPV vaccine work for?

at least 8 years

What is the current status of HPV vaccination?

global coverage with the first dose of HPV among girls is decreasing at a alarming rate, particularly in low-income countries

What are the reasons for slow HPV vaccine uptake in Kenya?

• lack of awareness and knowledge gaps

• fear of side effects

• religion

• misinformation

• communication with health workers

• limited health resources

• corruption

• cost and need for 3 doses

What are the three stages of breast cancer screening?

1. self breast exams

2. clinical examination

3. mammography