Cervical Cancer Prevention and the Millennium Development Goals/ Prevention Du Cancer Du Col Uterin et Objectifs Du Millenaire Pour le developpement/Prevencion del Cancer Cervicouterino Y Objetivos De Desarrollo del Milenio
Wittet, Scott, Tsu, Vivien, Bulletin of the World Health Organization
Cervical cancer kills about 270 000 women every year. (1) It has been called "a case study in health equity" because most (85%) of these deaths occur in the developing world. In large part, this inequity is due to the lack of cervical cancer screening programmes in those countries--the same programmes that are taken for granted in Australia, Europe and the United States of America. And since cervical cancer affects relatively young women (mortality rates climb as women enter their forties), it results in many lost years of life--2.7 million age-weighted years of life were lost to the disease in the year 2000. (2)
The biggest impacts of cervical cancer are on poverty, education, and gender equity--the first three Millennium Development Goals (MDGs). Many of those who die are bread-winners and caretakers of both children and elders. For example, in sub-Saharan Africa women head one-third of all households and in Botswana, over half of the children who have lost a parent are being cared for by grandmothers women also at risk of cervical cancer. (3,4) The fabric of the family and the community is weakened significantly when these women die. This is especially true in communities also ravaged by the loss of working adults to HIV/AIDS.
In addition to the emotional trauma, cervical cancer deaths have significant economic costs over the short- and long-term (though these are seldom considered when calculating the financial burden of disease). Family members may lose work opportunities and can incur overwhelming medical costs while caring for women with cancer. (5) Reduction in family income resulting from the death of a working-age adult can force remaining family decision-makers to prioritize immediate needs (food and shelter) over investment in human capital (e.g. education). As poverty increases, more children (especially girls) may be kept out of school for lack of school fees, books, or uniforms, but also so that they can contribute to family income through work. Cervical cancer can impact education in other ways as well, such as when schools lose experienced teachers to the disease. The differential economic and social impact on women and girls makes it more difficult to achieve gender equity. Finally, it should be noted that lower levels of female education are linked to decreased maternal and infant health--the focus of two other MDGs.
Developing successful cervical cancer screening and human papilloma-virus (HPV) vaccination programmes opens the door to many other interventions including, for older women, opportunities to screen for other cancers and reproductive problems, and for school-age girls and boys, deworming; treatment for schistosomiasis, onchocerciasis, filariasis and trachoma; iron and/or iodine supplementation; distribution of bed nets to prevent malaria; hand washing, anti-tobacco and anti-drug education; nutritional supplementation; body-awareness education; and guidance on life choice decision-making and sexual health. …