Are you Cervical Health aware? Prevention first!
22 January 2020
January is Cervical Health Awareness Month, a chance to talk about risks and prevention as well as raise awareness about cervical cancer diseases and how women can protect themselves from HPV (human papillomavirus), through screenings and vaccinations.
According to the World Health Organisation, the global cancer burden in 2018 is estimated to have risen to 18.1 million new cases and 9.6 million deaths. One in 5 men and one in 6 women worldwide develop cancer during their lifetime, resulting in one in 8 men and one in 11 women dying from the disease.
New incidences of cervical cancer account for 3%, or 570,000 of these figures, according to the International Agency for Research on Cancer (IARC) with 270,000 women dying from the disease – that’s one woman every two minutes.
Virtually all cervical cancer cases (as well as more than 90% of all anal cancers) are caused by the human papillomavirus (HPV). HIV and HPV are dual epidemics that fuel each other in a deadly vicious circle: people living with HIV are at higher risk of contracting HPV and developing HPV-associated cancers, while infection with HPV increases susceptibility to HIV. Smoking may also increase the risk of cervical cancer for women who have HPV.
What is particularly shocking about these figures is that cervical cancer, unlike many cancers, is largely preventable.
What’s driving these numbers around the world?
Global cervical cancer trends
|Regions||2018 Incidence per 100,000*|
|Latin America and Caribbean||17.0|
Low and middle-income regions often lack the medical and education awareness programmes to protect the population against specific diseases, and major initiatives are required to achieve high coverage of vaccination and cervical screening. Some 90 per cent of deaths from cervical cancer take place in these regions.
The highest prevalence is in Africa, with Swaziland and Malawi ranking highest in 2018, with 75 and 73 cases per 100,000. Only seven countries in Africa - Tanzania, Uganda, Rwanda, Botswana, Mauritius, Seychelles and South Africa - have introduced the human papilloma virus (HPV) vaccine into their immunisation programme.
In Southeast Asia, cervical cancer is the second most common cancer in women, with roughly 175,000 new diagnoses annually.
In the Middle East and North Africa, a recent study suggests that deaths from cervical cancer, the second most fatal cancer for women in the region, will double by 2035 unless conservative nations vaccinate young women and tackle sexual taboos.
Encouragingly, progress is being made in the United Arab Emirates, with Abu Dhabi leading the region in giving schoolgirls free vaccinations over the last ten years.
The latest research does imply that the elimination of cervical cancer could be on the horizon for high-income countries, but the evidence suggests that this may be dependent on boys also being included in national vaccination programmes.
One such country with strong screening and vaccination protocols is Australia, which is on track to eradicate cervical cancer within the next 20 years, potentially the first country to do so. The current rate in Australia is 7 cases per 100,000, compared to 10 per 100,000 in the UK.
A study in the Lancet Public Health Journal has shown that if vaccination and screening continue at their current levels in Australia, cervical cancer rates will drop to less than 6 in 100,000 by 2022 and to below 4 in 100,000 by 2035. As well as high vaccination coverage amongst both girls and boys, experts say the country’s screening programme is also behind the drop in the number of cases.
Why is screening important?
The symptoms of cervical cancer are not always obvious. In fact, none may be evident until an advanced stage of the disease has been reached. This is why it’s important for women to schedule and attend cervical screening appointments, with 3-yearly tests recommended by many health providers.
Some countries, including the UK, provide screening as part of their standard healthcare. However, this is not necessarily the case worldwide. Globally mobile women living and working overseas should therefore check that their health insurance policy covers such screening and vaccinations– such as the Global Choice Out-patient plan.
The majority of HPV infections found during screening do not cause symptoms or disease and resolve spontaneously within a few months.
As the HPV infection causes nearly all cervical cancer, vaccination is a powerful weapon in the war against this stealthy disease. Persistent infection with specific types of HPV (most frequently types 16 and 18) may lead to precancerous lesions which, if untreated, may progress (sometimes over many years) to cervical cancer.
What prevents take-up of available screening and vaccination?
Whilst a lack of screening availability and vaccination programmes are a barrier for many women, particularly in economically-deprived areas, misunderstandings and lack of awareness can prevent women from taking advantage of available services, even when they are readily available.
In the UK, data has shown that as many as 1 in 3 women did not take up their invitation for a Smear (PAP) Test in the period 2016-2017. Research from UK charity Jo’s Cervical Cancer Trust indicates that:
- 61% of women aged 25 to 35 were unaware they were in the highest-risk group for cervical cancer
- 37% thought screening did not reduce your risk of disease
- 24% thought they were not at risk because they were healthy
- 17% thought Smears were important but didn't know why
- 11% thought you didn't need a Smear if you'd had the HPV vaccine
In addition, this study found that some of the reasons that women didn’t attend were:
- Embarrassment about their body shape, appearance or smell
- Having to take time off work
- It was too hard to make an appointment
- Would rather not know if something was wrong
- Didn’t know where to get the test
Having a Smear Test takes less time than making a cup of tea, that’s why we would urge every woman to include cervical screening in their health routine, and encourage female friends, sisters, daughters and mothers to do the same. You can potentially save a life.
How can Generali Global Health’s Global Choice plan help?
Genomic profiling for cancer treatment
Generali Global Health polices offer genomic profiling to any of our members diagnosed with cancer. This easy-to-access service simply involves analysis of a saliva sample. Our healthcare partners then recommend a personalised cancer treatment programme, designed to provide the best healthcare outcomes based on an individual’s genetic profile.
Outpatient cover: HPV vaccine
Vaccinations must have completed clinical trials and be approved for use in the country where treatment is taking place. The cost for the visit and administration of the vaccination is included.
Outpatient cover: (PAP) Smear Test
We will pay for one health assessment per period of cover to assess your state of health where it is provided in one single medical facility, by a recognised medical practitioner/ specialist or qualified nurse, all the tests are undertaken in the same consultation and results are provided as a single medical report. The actual tests you have will depend on the health screening offered by your provider but may include routine tests such as blood sugar and cholesterol tests, a blood pressure test and a kidney function test. It may also include specific screening tests, such as mammogram, PAP test, colon cancer screening, or prostate cancer screening.