By Elesha George
Cervical cancer is the only type of cancer that no woman has to get, yet a significant number of women in Antigua and Barbuda die from it each year.
It is the fifth leading cause from death in cancer patients – both male and female – and the third leading cause of death in women in the twin islands. And those are the statistics that the Ministry of Health is attempting to reduce by introducing the use of a new high-performance human papillomavirus (HPV) test.
Cervical cancer is caused by HPV which affects both males and females who are sexually active.
Cases of patients with cervical cancer in Antigua and Barbuda are increasing according to healthcare professionals, and those recorded at the Oncology Department at the Sir Lester Bird Medical Centre have doubled in teh last two years, according to Dr Cherrie Tulloch, chairperson of Antigua’s Cervical Cancer Task Force who also noted that most diagnosed cases are pre-retirement age (below 60 years old).
Between 2019 and 2020, the hospital’s Gynecology Department also found 10 cancer cases from cervical biopsy results.
“If you take the number of women who are being diagnosed – new cases – from the figures between 2001 and 2005 – and you superimposed it on the figures that came out for the Caribbean in 2020, Antigua and Barbuda would be one of the countries with the highest incidence rates.
“We’d be up there with Jamaica and Trinidad and Tobago and that’s what we intend to turn around,” she explained.
For the next six months, hundreds of women will have an opportunity to participate in a pilot project – the National Cervical Cancer Prevention Programme – that will use this type of testing to help eliminate instances of cervical cancer in women.
The Ministry of Health is working with the Pan American Health Organization (PAHO) to identify women at risk. The test will run in conjunction with the traditionally used pap smear which for years has been the foremost protection against cervical cancer.
Acting Chief Medical Officer Dr Teri-Ann Joseph said, from Monday, women can register at various clinics to have those tests done. Each clinic has the capacity to register up to 50 patients per month.
“Beginning on Monday 12th September 2022, our women will have access to pap smears and HPV tests at the All Saints, Clarehall, Browne’s Avenue, Jennings and Grays Farm clinics,” she shared.
The project will target 1,500 women between the ages of 30 to 49 over a six-month period. That number accounts for 11.6 percent of women who have not currently tested for HPV. To meet the criteria, women must have not received cervical screening in the last three years, have had abnormal screening in the last three years, have no history of hysterectomy and are not currently pregnant.
Speaking to its advantages, Dr Tulloch said the HPV test is more efficient, is more likely to turn out less false positives and is superior to cytology in identifying women at risk of developing cervical cancer.
“If every woman in Antigua and Barbuda does two HPV DNA tests in their lifetime, we can significantly decrease the mortality associated with cervical cancer,” she remarked.
While cervical cancer is a preventable disease and curable if treated early and adequately, it is one of the most common cancers and cause of cancer-related deaths in women across the world. As far back as the 1980s, data produced by local doctors showed that cervical cancer was the second most common cancer being diagnosed in women here in Antigua and Barbuda.
“And even again when they looked at those figures in the 2000s, it was the same picture,” Dr Tulloch noted.
The project is the last of a two-tiered programme to eliminate cervical cancer among the population by adopting early detection methods through cervical cancer screening and offering treatment to those affected. The first phase began in 2018 with the launch of the HPV vaccination programme.
The PAHO has supported the country with technical training, as well as equipment and tests to start the project. The organisation has also provided machines that can help treat women diagnosed with cervical cancer.
Basic Health International (BHI) – a non-profit organisation which dedicates its time to reducing cervical cancer in Latin America and the Caribbean – has also worked closely with the ministry on this project since discussing its possibility with nurse Valarie Williams, Non-Communicable Disease (NCD) Coordinator in the Ministry of Health, in 2015.
“Over this past year BHI has helped PAHO facilitate and train a cadre of healthcare workers in HPV implementation and training. We’ve helped guide the Cervical Cancer Task Force, we have done a needs assessment visit with the task force to all the clinics involved in the pilot and have trained the nurses at those clinics to get them ready for implementation,” said Dr Rachel Masch, BHI’s Chief Medical Officer.
Antigua and Barbuda is the first country in the Eastern Caribbean to implement HPV testing as part of their national cervical cancer prevention programme.
