Challenges to Cervical Cancer in the Developing Countries: South African Context

Abstract

Despite the fact that cancer of the cervix is preventable, it is the commonest cancer cause of death in women in sub-Saharan Africa, Melanesia, South Central and South East Asia, the Caribbean and Latin America (Parkin et al., 2005). Southern Africa has one of the highest incident rates in the world, and in South Africa alone it caused the deaths of 3 700 women in 2002 (Denny, 2006). According to the International Agency for Research on Cancer (IARC), cervical cancer accounts for 23% of all cancers diagnosed in South Africa (International Agency for Research on Cancer, 2006 as cited in le Riche, 2006). Cervical cancer is the second most common cancer among South African women, with 1 in 41 women developing the disease in her lifetime (Sitas et al., 1998). Adar & Stevens (2000) noted that it was responsible for nearly 2% of deaths of women aged 15-44 years and 4% of women aged 45-59 years. In South Africa, the total age-adjusted incidence rate (ASIR) of cancer in Africans is far lower than that in the corresponding white population. According to the KwaZulu-Natal Department of Health (2004) in South Africa, cervical cancer accounts for 18.5% of female cancers, with approximately 5 000 new cases reported annually and black women being most at risk of getting cervical cancer compared to white and coloured women. African women seek help only when their particular disorder/disease is far advanced, thereby, as in the case of cervical cancer, rendering cure or control nearly impossible (Walker et al., 2002). A study done by De Jonge et al. (1999) found more aggressive tumours in black women compared to white women with cervical cancer in South Africa. In women of all race groups, the age specific cervical cancer rates for 1992 remained low up to 30 years of age, but thereafter increased rapidly until they peaked at 50 to 59 years (Denny, 2006). Similarly, Sitas et al. (1998) reported that the incidence of invasive cancer rises in the age group 35-39, with 87% of cases occurring in women over 35 years of age. It is a common cancer in poor women due to inadequate mass cervical cancer screening, and their cure rates are low as they present late (Denny, 2006).