Cervical cancer of the cervix uteri (the neck of the uterus), is the third most common cause of cancer deaths in American women [after lung cancer and breast cancer] (The free medical dictionary).

Cervical cancer remains the second most common cancer diagnosed in women in South Africa with an estimated 7,735 new cases in 2012 and 4,248 women dying from the disease (ICO/IARC Information Centre on HPV and Cancer South Africa Human Papillomavirus and Related Cancers, Fact Sheet: 2018).

The very high incidence of cervical cancer is particularly tragic in an era where advances in medical science have proven cervical cancer as a potentially preventable disease. Although cancer kills more people globally than HIV/AIDS, tuberculosis and malaria, in most developed economies cervical cancer has become very uncommon due to successful screening and other preventive strategies.

Cancer of the cervix uteri is the third most common cancer amongst women worldwide, with an estimated 569,847 new cases and 311,365 deaths

in 2018 (GLOBOCAN). The majority of cases are squamous cell carcinoma followed by adenocarcinomas. (Vaccine 2006, Vol. 24, Suppl 3; Vaccine 2008, Vol. 26, Suppl 10; Vaccine 2012, Vol. 30, Suppl 5; IARC Monographs 2007, Vol. 90)

Cervical cancer incidence in South Africa

This section describes the current burden of invasive cervical cancer in South Africa and in comparison, to geographic region, including estimates of the annual number of new cases, deaths, incidence, and mortality rates.

Figure 1

Cervical cancer incidence in South Africa (estimates for 2018)

 Data accessed 5 October 2018

Figure 2

Cervical cancer incidence in South Africa by cancer registry

Data accessed 5 October 2018.

(Human Papillomavirus and Related Diseases Report SOUTH AFRICA Version posted at www.hpvcentre.net on 17 June 2019 at Human Papillomavirus and Related Diseases Information Centre).

HPV is contracted by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if he or she have had sex with only one person. Symptoms can develop years after a person had sex with someone who is infected. This makes it hard to know when a person first became infected. HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

How HPV and the health problems it can cause be prevented

• The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. CDC recommends HPV vaccination at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. (https://www.cdc.gov/vaccines/vpd/hpv/public/index.html)
• Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.
• Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV;
• Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Reference

1. Social and psychological impact of HPV testing in cervical screening: a qualitative study
   K McCaffery, J Waller, J Nazroo, and J Wardle. School of Public Health, Edward Ford Building (A27), University of Sydney, Australia. Department of Epidemiology and Public Health, London, England.

1. Human papillomavirus (HPV). World Health Organization.
2. https://www.who.int/immunization/diseases/hpv/en/