Page 35 - IB MAR 2019

Health

The curable cancer Figure 4: Age-standardised incidence rates of cervical cancer in regions
of Oceania (estimates for 2018)
killing Pacific women 30 277

Renewed calls for national actions on 25 18.6
cervical cancer 20 12.6

15
10 6.0
By Peni Komaisavai
5
LATE detection and late presentation contribute to the high num-
ber of women who die from cervical cancer in the Pacific each year. 0
The HPV Information Centre reports that an estimated 1,268 Melanesia Micronesia Polynesia Australia & New Zealand
Pacific Island women died from cervical cancer last year. The Cervical cancer: Age-standardised incidence rate per 100,000 women
rate of diagnosis and death is highest in Melanesia, followed by World Standard Female (All ages)
Polynesia and Micronesia. Source: HPV Information Centre
“The fact that it is curable and yet still able to claim a lot of
lives in Fiji, across the region and all around the world is really
saddening,” said Pacific Society of Reproductive Health President, for follow up on abnormal pap smears.
Dr Pushpa Nusair. Dr Fitzgerald and other Fijian and Australian volunteers are
In Fiji, cervical cancer is the third main cause working to screen Pacific Island women for HPV
of mortality in women; the leading cause of In Oceania every year: infection and provide point-of-care treatment.
cancer death among reproductive women; and Last year they screened 316 women in Fiji’s
the leading cause of mortality in all cancer types. • ABOUT 2,456 new cervical cancer Western division, and a similar effort will get
“The biggest problem that we have in Fiji and cases are diagnosed under way this August.
in all the Pacific is that women tend to present • Cervical cancer ranks* as the 9th From the front line
us in the very latest stages where we cannot do leading cause of female cancer Women living with cervical cancer are affected
very much for them,” said Dr Nusair. • Cervical cancer is the 3rd most both physically and mentally. Towards the later
She said by that time, medical officers can only common female cancer in women stages of the cancer, they can be socially isolated
offer patients palliative care. aged 15-44. and shunned by even their loved ones.
Prevention and treatment of cervical cancer has • About 1,268 new cervical cancer “It is one of the most horrible cancers for a
been a stated priority of the Pacific Islands Forum deaths occur person to have,” said Dr Pushpa Nusair. “All can-
for several years. Forum Secretary-General Dame • Cervical cancer ranks* as the 7th cers are horrible, but you know this happens in
Meg Taylor has called it development issue, “al- leading cause of female cancer a private region, where the woman suffers from
beit largely perceived as a women’s reproductive deaths very smelly discharge and at times get shunned
health issue.” • Cervical cancer is the 2nd most by her loved ones because of the foul smell.”
The World Health Organisation recommends common female cancer deaths in “Sometimes the connection takes place in
vaccination against the cervical-cancer causing women aged 15-44 between her bladder and vagina so she will be
human papillomavirus (HPV) should be included passing out urine uncontrollably, sometimes
in national immunisation programs, initially tar- Source: ICO/IARC Information Centre on HPV connection happens between the rectum and the
and Cancer 2018
geting girls 9-14 years of age, before extending mouth of the baby bag so you will have faeces
to 9-18 years. coming out of the vagina.”
WHO says the vaccine was introduced in Palau and Guam in “The very sad thing is that they get shunned by their families
2007, the Commonwealth of Northern Marianas and American and close relatives, so they are not only dealing with the pain
Samoa in 2009, FSM and Marshall Islands in 2010, New Cale- that they have to bear with but also with, the smelly discharge,
donia in 2011, and Fiji and Wallis and Futuna in 2013. Solomon and it is very undignified and sad.”
Islands aims to introduce the vaccine next year, and the ADB is Islands Business was fortunate enough to be speak with one
looking to support its introduction in Samoa, Tonga, Tuvalu and patient at CWM, ‘Mere’* who was recently hospitalised because
Vanuatu. Similarly, Australian and New Zealand Rotary Clubs are of the symptoms of cervical cancer.
looking to support immunisation efforts in Cook Islands, Nauru, Mere, who is in her forties, shared how at times she felt men-
Niue and Tokelau. strual pain and did not know what was going wrong with the
However the availability of the vaccine is no guarantee of suc- changes in her body, until she was admitted to hospital.
cess. The WHO says in many of these jurisdictions, the vaccine is She described how she was fit one moment and then out of
not administered consistently due to cost constraints, geographic nowhere, she started experiencing severe headaches and ab-
challenges, logistical problems and community concerns and fear. dominal pains.
Meanwhile, Dr Nicola Fitzgerald, who leads the Pacific Island The way Mere described it, the cancer hit without warning.
Cervical Cancer Screening Initiative, says screening efforts in But as we have heard, for Mere and the many Pacific women
Pacific islands often have slow turnaround times for results, like her, cancer could have been avoided through implementation
and this can result in a low rate of follow up and treatment, She of national screening and immunisation programmes.
attributes this in part to a small medical workforce, difficulty in
women getting to clinics and medical centres, and poor attendance *Name changed for privacy

Islands Business, March 2019 35