Zimbabwe: Women shun cervical screening exams

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ONLY 13 percent of Zimbabwean women have had a cervical screening exam in a country where the disease is the leading cause of deaths in women, statistics from the 2015 Zimbabwe Demographic Health Survey (ZDHS) show.

Nationally, 79 percent of women report that they have heard of cervical screening which can detect the disease early while it is still treatable but only 13 percent have ever had a cervical exam.

“Cervical cancer screening via the Papanicolau (Pap) test or the Visual Inspection with Acetic Acid and Camera (VIAC) are effective for detecting early abnormal or cancer cells in the cervix and uterus. The Pap and VIAC tests are recommended for women from the time they become sexually active,” says the report.

“Among those who report having a cervical exam, 90 percent report having the exam in the last three years and 66 percent had their cervical exam within the last 12 months.”

The report says women in urban areas are three times more likely than their rural counterparts to report ever having a cervical exam (21 percent and seven percent, respectively).

“Women in Harare (24 percent) and Bulawayo (21 percent) have the highest percentages of women who report ever having a cervical exam, and women in Manicaland have the lowest percentage (six percent). As education and wealth increases, so does the likelihood of a woman having a cervical exam,” reads the report.

Statistics from a study carried out in 2012 by the Zimbabwe cancer registry shows that cervical cancer is the most dominant type in women with a prevalence of 32 percent.

Mrs Junior Mavhu of the Cancer Association in Zimbabwe said cervical cancer remains a prevalent disease though it is treatable.

“Cervical cancer does not present any signs and symptoms unless at an advanced stage hence the need to have women going for the exams. Its symptoms can only be detected during an exam and all women must ensure they undergo tests,” said Mrs Mavhu.

A cervical screening exam

“If all women got examined early cervical cancer would not kill many women as it is doing now. For a country like Zimbabwe, it is cheaper for us to prevent than treat cervical cancer.”

According to the National Cancer Prevention and Control Strategy for Zimbabwe 2014-2018 more than 5 000 new cancer cases are diagnosed (all types) in Zimbabwe annually.

“Experience has, however, shown us that this is just the tip of an iceberg as many cancers are not captured by the routine National Health Information System because patients do not present themselves for treatment, or some deaths are not registered.

“Of those who do report, the majority are already at an advanced stage of the disease due to limited access to screening services,” read the strategy.

The cancer treatment and palliation services are unable to meet the existing demand.

“Additionally, and despite great progress in reducing HIV prevalence in recent years, Zimbabwe remains one of the countries most heavily burdened with HIV with an adult prevalence rate of 15%. The large number of people living with HIV results in an even higher number of people who will develop cancer.”

The report says the number of people developing cancer is expected to increase due to HIV/Aids and other infections, unhealthy lifestyle choices and an ageing population.

“The majority of cancers present at an advanced stage when management is more costly and treatment outcomes are poorer. This is mainly due to lack of access to early detection (screening and diagnosis) compounded by human and material resource constraints and general lack of awareness.
Zimbabwe only has two functional public health centres offering diagnostic and treatment facilities for cancer.

Mrs Mavhu said the two institutions are Mpilo Central Hospital in Bulawayo and Parirenyatwa Group of Hospitals in Harare.

“The other institution offering the same services is a private one in Newlands,” said Mrs Mavhu.

She said patients as a result incur a lot of transport, food and accommodation costs to seek services in either Bulawayo or Harare.

“Limited availability of resources, including chemotherapy medicines, opioid analgesics and cancer control skilled manpower further compromise patient care in the country,” reads the cancer strategy.

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