Cancer of the cervix is the second most common cancer in women worldwide, with about 500,000 new cases and 270,000 deaths per year (1, 2, and 3). Worldwide, every two minutes, a woman dies of cervical cancer (2, 3). Nearly 90% of these deaths occur in low income countries (2), where more than 95% of women have never had a pap test(1). Sub Saharan Africa and South America have the highest incidence of cervical cancer (3).
In Uganda, about 7.19 million women aged >15 years are at risk of the disease (4). The age standardized incidence is 45.6/100,000 while the age standardized mortality is at 25/100,000(4). Annually, 2,429 cases are diagnosed and 1,932 (80%) die annually. Furthermore, 80% of the women diagnosed with cervical cancer have advanced disease, usually stage III/IV, and the 5 year survival rate stands at approximately 20 %( 5). Up to 65% of Gynaecology beds at the national referral hospital are occupied by cervical cancer patients where cervical cancer causes 70% of gynaecological deaths (4).
Cancer of the cervix is largely preventable, but why is it the most common cause of cancer death among women in the developing world? The explanations include lack of organized screening programs (1, 2), the low level of education of women and limited access to health information (2), competing health care priorities (e.g. maternal and perinatal mortality, AIDS or TB) (2), and lack of widely available vaccination programs (2).
In an effort to reduce the burden of cervical cancer, medical students in Uganda created a SCORA project “Cervical Cancer Awareness Campaign”. The major objective of the project is to sensitize the community about the cancer and provide free screening as well as appropriate interventions. The project is run as a two phase campaign; phase I has both fundraising and cervical cancer awareness (a fundraising Marathon, radio talk shows, vaccination advocacy campaigns and training workshops for volunteering students), and phase II consists of village outreaches to selected underserved communities in the nearby districts. The outreaches involve health education, free cervical cancer screening programs, and referral of patients with precancerous lesions and invasive cancer to the university hospitals for treatment.
Since the establishment of the project, we have been able to reach over 10,000 people through radio and social media, and we have offered free cervical cancer screening services to about 1500 women nationally. A significant increase in the number of women that turn up for screening at university hospitals during the weeks of the campaign has also been noted. This campaign is scheduled to run for three years and the project is now a signature event for FUMSA-Uganda. In the future, we hope to offer cervical cancer screening services to 3000 women per year for five years at a fixed facility. Our dream is to raise money to equip one of the five cryotherapy centres in the country such that it is capable of handling those referred with precancerous lesions.