Every year, half a million women worldwide fall ill with cervical cancer - and about half of them die from the disease. With the right political and medical efforts, the number of people affected by cervical cancer could be reduced by up to 90 percent, writes the UN Population Fund UNFPA.
According to the latest available statistics, cervical cancer is the fourth most common type of cancer among women globally, with 528 new cases and 000 deaths each year. Most cases occur in low- and middle-income countries where there are no national cell sampling programs. Compared with Sweden and other Western European countries, the number of deaths due to cervical cancer is up to 10 times higher in Eastern Europe and Central Asia. There, the disease is the second deadliest type of cancer among women with 18 deaths annually.
An important reason for prioritizing efforts to prevent cervical cancer is that it mainly affects younger women. The majority of new cancer cases are registered in women aged 35 to 45 years. It is a time when most women both work and raise children, which means that the social and economic effects of cervical cancer have consequences that include far more than health effects and suffering at the individual level.
Women are discriminated against in health care
Eastern Europe and Central Asia are characterized by large inequalities in how people have access to and use reproductive health care. All countries in the region have signed most human rights conventions guaranteeing reproductive rights, but in many places the inclusion of reproductive rights in national legislation has been slow. Social and political barriers form the basis for gender discrimination in health care. In recent years, increased conservative values have further intensified discrimination.
Implementing well-functioning programs to prevent and treat cervical cancer is challenging because it requires coordination between several different types of services at all levels of health care. In Eastern Europe and Central Asia, prevention programs are often not systematic enough and cell sampling is carried out randomly, at the request of a patient or doctor, or when women consult a doctor for other reasons, rather than through organized national sampling programs.
Although most countries in the region offer free cell sampling and cancer treatment, very few countries cover the cost of following up a cell sample with cell changes, which is necessary to reduce the frequency of new cancer cases.
Almost all cases of cervical cancer can be prevented
With an effective cell sampling program, the number of cases of cervical cancer can be reduced by up to 80 percent, or by up to 90 percent if combined with HPV vaccination of girls and young women. An effective program must systematically call in women to be tested, review test results and offer treatment for positive test results, and ensure that these services are of high quality. A systematic program ensures that as many women as possible are tested and provides the most cost-effective reduction in cancer incidence.
With financial support from Sweden and other important donors, the UN Population Fund, UNFPA, has launched a regional initiative to prevent cervical cancer in Eastern Europe and Central Asia. Through the initiative, UNFPA's regional offices and country offices have jointly assisted countries in the region in identifying deficiencies in the national capacity to prevent and treat cervical cancer, set up regional web-based courses for healthcare professionals in detecting and preventing cancer, and designed training to train people to train. others in their immediate area.
By collaborating with governments, civil society and local caregivers, UNFPA has launched cell sampling programs in, for example, Georgia and Moldova. Since 2008, 44 women have been tested annually for cervical cancer in Georgia through a partnership program between UNFPA and the Government of Georgia.
UNFPA is expanding the program to ensure that more women have access to regular cell sampling and the necessary follow-up and treatment for positive test results.
It is important that decision makers understand that cell sampling and HPV vaccination are key components of a successful program against cervical cancer, but that these must be combined with a free follow-up treatment in the event of a positive test result to provide a cost-effective reduction in cancer cases. The international community can also help support national efforts by funding programs aimed at building the capacity of local health systems to implement a systematic program against cervical cancer.
With these measures in place, today's high rate of cervical cancer in Eastern Europe and Central Asia may soon be a thing of the past.
Pernille Fenger
This is a debate article. The author is responsible for analysis and opinions in the text.
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