Scaling up cervical cancer prevention in Tanzania

Daisy WinnerBlog, Featured, Tanzania

[January is Cervical Cancer Awareness Month – a fitting time for a story about our support for Tanzania’s efforts to scale up prevention and treatment of the cancer that causes more deaths than any other among African women.]

Cervical cancer is almost 100 percent preventable. Screening and treatment can detect and eliminate pre-cancerous lesions before cancer develops, and vaccines have been developed that are effective against the strains of the human papillomavirus that cause most cervical cancer.

Cervical cancer mortality disparities. Click on the map to view full size.

Cervical cancer mortality disparities. Click on the map to view full size.

But every year, more than 500,000 women are diagnosed with cervical cancer and over 266,000 women die from the disease. An overwhelming majority of these women (over 85 percent) live and die in low- and middle-income countries. Cervical cancer ranks as the leading cause of cancer and cancer deaths for women in sub-Saharan Africa. And Eastern Africa suffers from by far the highest mortality rate in the world at 27 cervical cancer deaths for every 100,000 women – nine times the rate in the United States.

As GHSP Nurse Educator Elisa Vandervort observes, “Cervical cancer is very real in Tanzania. Most individuals have a family member, friend, or neighbor who has died from cervical cancer.”

Since arriving at the University of Dodoma (UDOM) School of Nursing and Public Health, Vandervort has been working with her Tanzanian colleagues to reduce mortality from cervical cancer by supporting efforts to increase access to life-saving screening and treatment for women in their communities.

Tanzanian nurses (left to right) Nice Moshi, Fulgencia Mvulla, and Gladys Tumbo examine images at a cervical cancer screening refresher training in Dodoma.

Tanzanian nurses (left to right) Nice Moshi, Fulgencia Mvulla, and Gladys Tumbo examine images at a cervical cancer screening refresher training in Dodoma.

In November, Vandervort and a Tanzanian OB/GYN physician colleague, Caroline Damian, organized a refresher course in cervical cancer prevention at Dodoma Regional Referral Hospital. The training focused on a screening and treatment model that has been proven to be highly effective and affordable in low-resource settings — detection using visual inspection with acetic acid (VIA), which makes lesions visible by applying white vinegar to the cervix, and treatment with cryotherapy, which eliminates lesions by freezing the cells in the affected area.

Since the training, Vandervort has continued and expanded her cervical cancer work in four areas:

  • supporting cervical cancer prevention efforts at two Ministry of Health (MOH) sites in Dodoma Town that are training sites for UDOM’s nursing and midwifery students and also provide care for large numbers of high-risk women who have never been screened;
  • training university faculty and upper-year midwifery and nursing students in cervical cancer prevention;
  • collaborating with local MOH leadership and providers, UDOM, and NGO partners to build broad support for effective and sustainable cervical cancer prevention in Dodoma region; and
  • exploring and advocating for future technologies, including the possibility of a local demonstration project to implement HPV screening as a primary screening method for women with HIV.

“By supporting and participating in Tanzania’s capacity-building efforts,” Vandervort said, “we can empower communities, individuals, and the health system to find creative local solutions to this enormous health problem. Together we can prevent cervical cancer.”