Cervical Cancer

Cervical cancer arises from abnormal cell growth in the cervix, almost always linked to persistent infection with high-risk types of human papillomavirus (HPV). It is one of the most common cancers affecting women in Tanzania, but it is largely preventable and, if caught early, highly treatable.

• Often no symptoms in early or pre-cancerous stages, which is why screening is important
• Abnormal vaginal bleeding, including between periods, after sex, or after menopause
• Unusual vaginal discharge, sometimes foul-smelling
• Pelvic pain
• In advanced disease: leg swelling, back pain, or difficulty passing urine

• Persistent infection with high-risk types of human papillomavirus (HPV) is the main cause.
• Risk is increased by early sexual debut, multiple sexual partners, smoking, long-term use of hormonal contraception, high parity, and a weakened immune system, including HIV infection.
• Lack of access to HPV vaccination and cervical screening increases the risk of the disease progressing undetected.

• Screening using visual inspection with acetic acid (VIA), Pap smear, or HPV testing (depending on what is available locally) is used to detect pre-cancerous changes before cancer develops.
• Suspicious findings on screening or a visibly abnormal cervix are further evaluated with colposcopy and biopsy for tissue diagnosis.
• Once cancer is confirmed, staging investigations (such as pelvic examination and imaging) guide treatment planning.

Pre-cancerous changes detected on screening are treated at health centre or hospital level with cryotherapy, thermal ablation, or a loop excision procedure (LEEP), which are highly effective at preventing progression to cancer.

Early-stage invasive cervical cancer is treated with surgery, which may include removal of the cervix and uterus depending on stage.

More advanced disease is treated with radiotherapy, often combined with chemotherapy, at a specialised cancer treatment centre.

Any woman with abnormal vaginal bleeding or an abnormal-looking cervix on examination should be referred promptly for further assessment.

• HPV vaccination for girls, ideally before the start of sexual activity, as part of the national immunisation schedule.
• Regular cervical cancer screening for women in the recommended age range, even without symptoms.
• Consistent condom use, which reduces (though does not eliminate) the risk of HPV transmission.
• Avoid smoking, which increases the risk of cervical cancer in women with HPV infection.