Earlier this week, a comprehensive lecture on the causes, consequences, and prevention of cervical cancer was conducted for junior and secondary school students in the Central Region of Eritrea. The event, organized by the Ministry of Health (MoH), in cooperation with the Ministry of Education, took place in the main hall of Orotta Referral Hospital, the country’s largest medical facility.
In addition to the detailed lecture, which was delivered by leading local health professionals and experts, the event featured an extended question-and-answer period, as well as a general knowledge competition for students from 14 different secondary schools in Asmara. Notably, the program was generally well received by participants, with many expressing appreciation, as well as a greater understanding of the topics raised.
Taking off from the recent health awareness event, the following article sheds further light on the topic of cervical cancer, and its leading cause, human papillomavirus (HPV), with a particular focus on Eritrea.
A broad overview
According to the World Health Organization (WHO), a specialized agency of the United Nations, cervical cancer is the fourth most common cancer among women globally, with an estimated 604,000 new cases and 342,000 deaths in 2020. The vast majority of cervical cancer around the world – greater than 95 percent – is due to HPV. The most common viral infection of the reproductive tract, HPV is mainly transmitted through sexual contact and most people are infected with it shortly after the onset of sexual activity. (Although sexual transmission is most common, it can also be transmitted through skin-to-skin contact and from pregnant mothers to their babies.) As well, cervical cancer is, by far, the most common HPV-related disease. While HPV can cause disease in both females and males, it is highly gendered. Around the world, it is estimated that almost 90 percent of the global HPV vaccine-preventable disease burden falls on females.
Positively, however, when diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively. Furthermore, widespread immunization with the HPV vaccine can reduce the impact of cervical cancer and other cancers caused by HPV. Notably, years of empirical studies of HPV vaccines have shown almost 100 percent protection against the previously high-risk HPV strains that cause cervical cancer (types 16 and 18) and HPV vaccines are a cost-effective intervention in an array of settings and contexts worldwide.
Across the world, early protection is regarded as the best, and the primary target group for HPV vaccination is young or adolescent girls (aged 9 to 15 years). The consensus is that it is ideal for individuals to receive the vaccine before they have sexual contact and are exposed to HPV (since once someone is infected with HPV, the vaccine might not be as effective). It is worth noting that a considerable amount of empirical research conducted globally has also shown that receiving the vaccine at a young age is not linked to an earlier initiation of sexual activity or risky behaviors.
Although it is regarded as a genuinely global public health challenge that transcends borders, the fact is that approximately 90 percent of all new HPV cases and deaths worldwide in 2020 were in low- and middle-income countries. Moreover, despite the HPV vaccine providing a proven, cost-effective, and safe tool to protect women and girls, global coverage rates among girls continue to be extremely low, especially within countries of the developing world. (At present, only slightly over half of the WHO’s 194 Member States have introduced HPV vaccination into their national health programs.)
Focusing on Eritrea
In Eritrea, cervical cancer continues to be one of the most frequent cancers found among women in the country, with reports from recent years placing it behind only breast cancer. It is also one of the deadliest; at present, a significantly high percentage of cases in the country lead to death.
Of note, recent years have witnessed the MoH, in close collaboration with international and local partners, introduce the HPV vaccine into the national vaccination program with the aim of better protecting the health and well-being of girls and women in the country. Notably, with cancer screening and treatment services in the country still relatively limited in terms of scope and availability, which can result in patients being diagnosed with advanced-stage disease, providing widespread access to vaccination before HPV exposure is even more critical and necessary. (This is not to say, however, that HPV vaccination will replace the need for cervical cancer screening.) Importantly, at the same time as it helps to safeguard the health of women and girls in the country, the HPV vaccination can also play a positive role in enhancing socioeconomic development.
The general importance of raising awareness and understanding, especially within youth
One of the main goals of the recent lecture was to increase awareness and understanding of cervical cancer, which is fundamental to prevention and effectively reducing the national cancer burden. It is well worth noting that a large body of empirical work from around the world has compellingly shown how such initiatives can combat negative attitudes, plug gaps in knowledge, address misconceptions, and significantly contribute to positive health-related outcomes.
In the Eritrean case specifically, through creating a welcoming space for open dialogue and conversation, and providing young people – who remain an extremely vulnerable population – with the accurate, objective information and knowledge that they need, the lecture (along with others like it) seeks to empower young people and the wider Eritrean society to take timely and effective action to reduce the harm caused by a relatively easily preventable public health problem.
