Cervical cancer screening in Nigeria
Nigeria, a West African country is the 9th most populous country in the world. Approximately 6% of its estimated 140 million population reside in Lagos, a small state on the western coast
Adeola Olaitan, Consultant Gynaecologist at University College London Hospital saw an opportunity to use her skills and those of her colleagues to help prevent cervical cancer in Lagos . Backed by funding from the Institute for women's health, the Lagos cervical cancer screening project started in June 2006, with the aim of piloting a free simple test to prevent cervical cancer in women who would not otherwise be able to afford it.
It is possible to be screened privately in Lagos, but this costs at least 1,500 Naira (£12.50) in a country where many people earn just 6,000 Naira (£50) per month. Screening is usually done by cervical cytology which requires a sophisticated infrastructure. The cytology samples, once obtained, have to be sent to the laboratory for a qualitative analysis. Interpretation of smears thus depends on expertise and strict quality control. There must be facilities in place for communicating the smear result to the patient and a repeat visit is then required for further evaluation and treatment if the smear is abnormal.
Visual inspection techniques avoid the need for repeat visits as abnormalities on the cervix can be recognised by the application of specific solutions (visual inspection with acetic acid (VIA) and visual inspection with Lugol's Iodine (VILI))and immediate treatment offered, thus ensuring better compliance.
Progress made
- 1,500 women have been screened
- 117 women have been diagnosed with pre cancer and treated
- 2 nurses and over 40 staff have been trained in the technique
- Over 3,200 women have been educated about cervical screening
- Equipment for two clinics have been purchased
- On average 50 women per week are screened daily. Staff are now working towards screening 75 women per week
Multiple reasons why cervical cancer is so common in Nigeria.
- Lack of an effective screening program
- Low awareness of cervical cancer, even among healthcare workers.
- In addition, the HIV epidemic has contributed to the incidence of this disease.
The Objective of the Cervical Screening Project:
The objective of the project is to determine the feasibility and acceptability of screening in sexually active women up to 70 years by using visual inspection techniques to detect signs of cancer or pre-cancer and to remove any pre-cancerous cells with cryotherapy. This technique has been extensively validated in India and South Africa and found to be an effective means to detect and treat pre-cancerous lesions.
Can you help?
A start up donation of £50,000 was awarded by the institute for women's health which has paid for the project to date.
An additional £100,000 is required to extend work at the existing clinic for two more years and to extend the project to two more clinics so that over 10,000 women can be screened in the next two years
Findings from the pilot study will be used to persuade the Nigerian government to implement a national screening and education programme. It is also hoped to roll the pilot out to other African countries
Please contact info@cancercareafrica.org or m.hill@ucl.ac.uk for further information on how you can help contribute to the much needed funding requirements.