When I was in Zambia I saw ways in which nurses treat cervical cancer in low resource settings. Women who do not benefit from the HPV vaccine and still develop cervical cancer are often subject to visual inspection of the cancer typically with a digital camera followed by cryotherapy to freeze the diseased part of the cervix. Some researchers question whether this approach to cervical cancer treatment is effective in low-and-middle income countries. Globally, the cervical cancer burden falls disproportionately upon women in low and middle-income countries. In fact, approximately 90% of deaths from cervical cancer occur in these countries like Bolivia, Guinea, and Swaziland. Rates are highest in Central America, sub-Saharan Africa, and Melanesia.
“These are women in their prime who are working, caring for children, and contributing to their communities. We have made huge progress in tackling other infectious disease and in reducing maternal mortality, so that women are now living long enough to develop diseases such as cancer and heart disease,” says Dr. Danielle Rodin, Clinician–Investigator and Radiation Oncologist, Princess Margaret Cancer Center.
Now, some researchers believe that radiotherapy is needed in order to treat cervical cancer in an estimated 9.4 million women in poor countries. Cervical cancer is the most commonly diagnosed cancer in 28 countries and the leading cause of cancer death in 42 countries. World-wide cervical cancer deaths are expected to rise to more than 440,000 deaths a year by 2030 up from 226,000.
“Vaccination is hugely important, but we can’t neglect the millions of women who are contracting cervical cancer and dying in pain without access to treatment. These are women who have curable cancers – even advanced cervical cancer can be cured with radiotherapy. The possibility exists to make this treatment universally available.”
While the prospect of saving more lives in low-and-middle income countries is noble, the matter of cost always comes into play. In 2015, only 35% of the world’s radiation facilities were located in poor countries. In order to treat women with cervical cancer in sub-Saharan Africa, Southeast Asia and Latin America with radiotherapy there must first be a facility where they can go.