According to data from the World Health Organization (WHO), cervical cancer is the fourth most common cancer in women worldwide. In 2018 alone, an estimated 570,000 women were diagnosed with cervical cancer worldwide, with approximately 311,000 dying from the disease.
“Cervical cancer is such a heavy burden on society,” says Dr. Ronald B. Capito, a gynecologic oncology specialist and Fellow of the Philippine Obstetrical and Gynecological Society (POGS).
In the Philippines, cervical cancer is the second most common cancer in women, most of which are diagnosed at later stages. Locally, about 7,190 new cases of cervical cancer are registered each year, with about 4,088 Filipinas dying from the disease each year2 (Estimates for 2018), says Capito. “If you look at it another way, 11 Filipinas die from cervical cancer every day,” he adds.
Human papillomavirus (HPV) infection is a key factor in the development of cervical cancer. HPV is a virus with more than 100 types. It can cause other diseases such as oropharyngeal cancer, recurrent respiratory papillomatosis, vulvar/vaginal cancer, anal cancer, dysplasia and genital warts. However, only 13 types of HPV can cause cervical cancer, Capito explains.
Nevertheless, it is one of the most common sexually transmitted viruses. Almost all sexually active adults have had HPV infection at some point in their lives and may not realize it simply because there are no symptoms.
The good news is that cervical cancer can be prevented with early and regular screening and vaccination. “In this day and age, with all the medical advances, cervical cancer might be preventable,” adds Capito.
Together in the fight against cervical cancer
To raise awareness of how to prevent cervical cancer, various Local Government Units (LGUs) launched a series of celebrations during the final Month of Cervical Cancer Awareness. These events included lectures by medical experts, a free HPV vaccination for young girls ages 9 to 14, and a free acetic acid (VIA) visual inspection for HPV screening.
MSD has partnered with the Department of Health (DOH) and Department of Education (DepEd) as well as medical society organizations such as POGS and private organizations such as the Ramon Aboitiz Foundation, Inc. (RAFI) in collaboration with various LGUs. to strengthen the paradigm shift to eliminate cervical cancer in the Philippines.
Meanwhile, in Quezon City and Cebu City, Cervical Cancer Awareness Month celebrations were held at Quezon City Hall and Il Corso Lifemalls, respectively, with the common theme, “A Paradigm Shift in Cervical Cancer Care Toward Elimination.” In addition, a ceremonial vaccination was performed during the event in Quezon City and a “Kalasag ng Kalusugan Commitment Exercise” was held to celebrate the joint efforts of different sectors in the fight against cervical cancer and to spread its awareness.
These events reflect the belief that all efforts must be coordinated and accelerated to reduce and eliminate cases of cervical cancer worldwide. According to the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer, each country must achieve the following global goals by 2030:
- vaccination: 90% of girls are fully vaccinated with the HPV vaccine by the age of 15
- screening: 70% of women are screened for cervical cancer with a high performance test by age 35 and again by age 45
- treatment: 90% of women with treated precancer and 90% of women with treated invasive cancer
The Philippines still has a long way to go to achieve these goals. For example, since the introduction of the HPV vaccine in 2015, only 9.3% of women ages 25 to 64 have had cervical cancer screening, and only 23% have been vaccinated with a full series, Capito said. “The good news is that we still have 10 years to work hard to achieve these goals,” adds Capito.
Local efforts to reduce the incidence of cervical cancer
The DOH runs several public health programs related to cervical cancer in partnership with DepEd and local government. These include early screening by, visual inspection with acetic acid (VIA) and HPV vaccination.
“Getting screened for cervical cancer as early as possible is critical to preventing the disease, especially since it doesn’t show any visible symptoms until the later stages,” said Van Phillip Baton, MD, director of the Central Visayas Center’s Noncommunicable Diseases Unit the health development of the DOH. It can take 15 to 20 years for cervical cancer to develop in women with normal immune systems; He goes on to explain that women with weakened immune systems only take 5 to 10 years to develop.
The DOH is redoubling its cervical cancer screening efforts. However, according to the WHO Philippines, only 1 in 10 Filipinas have been screened for cervical cancer in the past five years. Also, the national screening program for cervical cancer was only introduced in 2021. This includes the provision of guidelines for early detection at the primary care level and a clear referral system from the primary to the tertiary level of care.
The DOH is also increasing its efforts for HPV vaccination, particularly in children ages 9 to 14. “Vaccinations at a young age are ideal; That’s when the immune system is strongest and elicits a robust vaccine response with only mild side effects,” says Baton.
“It’s better before any sexual contact so that they are protected from HPV,” adds Erwin de Mesa, MD, an infectious disease specialist. This is especially true since HPV is transmitted through sexual intercourse and skin-to-skin contact in the genital area,” explains de Mesa.
Juliana Gonzalez, MD, Officer-In-Charge, and Eleen Gumpal, MD, Manager of the Las Piñas Municipal Health Department’s National Immunization Program, encourage people to take advantage of the free immunization programs offered by schools and local health centers.
In 2016, HPV vaccination was included in the DOH national vaccination program. However, according to the WHO Philippines, coverage of the national HPV immunization program among girls ages 9 to 14, its primary target cohort, remains low. As of 2020, only 1 in 10 girls, or about 30% of the primary target cohort, have received their HPV vaccination. Of that number, only about 5% were able to get their final doses of the HPV vaccine.
“It could be because the majority of healthcare workers are still focused on getting vaccinated against COVID-19,” says Baton. “For this year and next, however, we expect to scale up our school-based and community-based cervical cancer vaccination.”
Outside of these DOH programs, talking to your doctor is still the best way to get the right information about HPV and how to prevent cervical cancer, reminds Dr. Jennifer T. Co, obstetrician-gynecologist and infectious disease specialist. In addition, Co urges people not to self-medicate or to believe hearsay and fake news, as this could further complicate our understanding and dealing with cervical cancer as a disease.
Making a world without cervical cancer possible
“Cervical cancer can be prevented with early screening and proper medical advice. We hope everyone will find time to go to their local health centers and partner hospitals for regular screening, not just for cervical cancer but for other preventable diseases,” Baton said. Through the combined efforts of national and local governments and the private sector, the Philippines is on track to help reduce the incidence of cervical cancer and its burden on society. So get the right information and talk to your doctor today about early detection, prevention, and treatment options for cervical cancer.