AOGU’s Role in Cervical Cancer Prevention in Uganda
The burden of cervical cancer in Uganda is unacceptably high. The age standardized incidence is 45.6/100,000 while the age standardized mortality is at 25/100,000. Over 80% of women with cervical cancer are diagnosed with advanced disease, usually stage III/IV and the 5 Yr Survival rate stands at approximately 20%. Anecdotal reports indicate that cervical cancer causes 70% of gynecological deaths and over 40% of radiotherapy patients are treated for advanced cervical cancer. AOGU is working with Uganda Ministry of Health and several stakeholders to address cervical cancer prevention.
Current strategies in which AOGU is involved to address cervical cancer include:
- Policy formulation,
- Primary prevention,
- Secondary prevention,
- Management of cervical cancer, and
Policy formulation: Uganda Ministry of Health appointed a Technical Advisory Committee to guide the overall approach to cervical cancer prevention. The AOGU, PATH, Uganda Women’s Health Initiative and WHO are key members of this committee. AOGU is involved in writing the Cervical Cancer strategic plan and the training curriculum for screening with VIA and cryotherapy. Both documents will be completed within the next couple of months.
Primary prevention – HPV vaccination; AOGU, together with Child Health and Development Centre conducted a formative study that formed the basis for the current HPV vaccination demonstration projects by PATH and UNEPI. The demonstration project will be completed in June 2010.
Secondary Prevention – Screening and Treatment for pre-cancer; The Mulago Hospital Division Department of Obstetrics and Gynaecology, Makerere University School of Health Sciences, where a large number of AOGU members work has created an oncology department to address gynaecological cancers – particularly cervical cancer. AOGU is involved in in-service training of health providers including ‘Visual Inspection with Acetic Acid’, ‘Colposcopy’, ‘LEEP’, ‘Cryotherapy’ and ‘Train the trainers’ between 2007 and 2009. More training, supported by PATH, will be held in the next couple of months with the main trainers drawn from AOGU.
AOGU has spearheaded or supported advocacy at the Ugandan Parliament, in the print/electronic media as well as outreach cervical screening activities.
AOGU members at Makerere University and Uganda Women’s Health Initiative are engaged in research aimed at finding the most appropriate screening strategies for Uganda by comparing various screening modalities ranging from visual inspection methods to HPV DNA testing.
AOGU working with GOC/SOGC will soon implement more training in colposcopy, LEEP and surgery for invasive cervical cancer.
AOGU’s Past Projects Related to Cervical Cancer Prevention in Uganda
2009 Advocacy for cervical cancer screening
During the Launch of the Screening for Cervical Cancer, AOGU and the Uganda Women’s Health Initiative (UWHI) ran a cervical cancer screening clinic at the Sheraton Hotel, where the launch activities were being done. In all, about 90 women were screened and over 50 women referred for cervical cancer screening.
2007 Launching Cervical Awareness with Mama Tendo Foundation
AOGU and Uganda Women’s Health Initiative provided cervical cancer screening for participants at the Mama Tendo seminar. Mama Tendo Foundation is a local NGO that strives to improve family health through seminars, trainings and the media.
2007 Technical assistance to Child Health and Development Centre in conducting a situational analysis on an assessment of the readiness for introduction of a cervical cancer vaccine in Uganda. Financed by PATH.
2005 Cancer cervix screening and VVF management in Kampala District and Katakwi, District, Eastern Uganda – In collaboration with ACTION AID Uganda. Over 330 women were screened for gynaecological conditions including VVF and Cervical cancer and reviewed, and some (50) had surgical interventions done for cervical cancer and VVF repair.
Cervical Cancer Ressources:
Putting Cervical Cancer on the Agenda in Uganda, presentation by Dr. Dan Murokora given at the SOGC’s 2010 Annual Clinical Meeting in Montreal.
Shaping a Strategy to Introduce HPV Vaccines in Uganda from the Program for Appropriate Technology in Health (PATH), in collaboration with AOGU.
Shaping a Strategy to Introduce HPV Vaccines in Uganda: Formative Research Results from the HPV Vaccines: Evidence for Impact Project from the Program for Appropriate Technology in Health (PATH), in collaboration with AOGU.
Summary report on HPV and cervical cancer statistics in Uganda from WHO/ICO information centre on HPV and cervical cancer (HPV information centre)