CERVICAL CANCER PREVENTION STRATEGIES Z Mike Chirenje MD FRCOG Department of Obstetrics and Gynaecology University of Zimbabwe, Harare Zimbabwe

Problem in Zimbabwean women: Problem in Zimbabwean women: Female cancers registered in 2002 by site: Cervix uteri (771)25.9% Cervix uteri (771)25.9% Kaposi sarcoma (478)16.1% Kaposi sarcoma (478)16.1% Breast (304)10.2% Breast (304)10.2% Ovary (74)2.5% Ovary (74)2.5% Cervix corpus (40)1.3% Cervix corpus (40)1.3% Zimbabwe cancer Registry (2006). Therefore 1 in every 5 women diagnosed to have cancer had cervical cancer. Therefore 1 in every 5 women diagnosed to have cancer had cervical cancer.

Cervical cancer is often slow growing, with progressive generalised wasting for several months that creates difficult home care in low resources. Cervical cancer is often slow growing, with progressive generalised wasting for several months that creates difficult home care in low resources. Family members complain about the unbearable smell that is socially embarrassing and impossible to eradicate (unresponsive to antibiotics). Family members complain about the unbearable smell that is socially embarrassing and impossible to eradicate (unresponsive to antibiotics). Epidemiology and Treatment of Cervical Cancer :

Cervical Cancer Prevention Cervical Cancer Prevention Primary (e.g. delayed intercourse) Secondary: = Pap smear =Visual Inspection with acetic acid (Chirenje et al Lancet 1999) =Visual Inspection with acetic acid (Chirenje et al Lancet 1999) = Lugol’s Iodine = Lugol’s Iodine = HPV vaccination (Merck covers HPV types 6,11,16 and 18 and GSK covers types 16 and 18). = HPV vaccination (Merck covers HPV types 6,11,16 and 18 and GSK covers types 16 and 18). HPV types 16 and 18 cause 70% of cervical cancer cases