Wednesday, May 19, 2010

Easily preventable yet so many still die...

PNG is truely in a sad state of affairs when it cannot even roll out a basic program that will save thousands of women from certain pain and death. More women will continue to die from Cervial Cancer because the PNG Government doesnt care enough to start a National Prevention Program.

According the Global Cancer Statistics in 2002, Cervical cancer ranks as the most common cancer (age-standardised incidence of 40.4 per 100,000) and is the leading cause of death (age-standardised mortality of 22.6 per 100,000) among women in PNG. It is truely sad that our women continue to die unnecessarily. Yet, the Government sees itself fit to buy a K100 million jet for 'ministerial tours'.

Find below is an excerpt taken from the study titled 'Human Papillomavirus and Cervical cancer in Australasia and Oceania: Risk Factors, Epidemiology and Prevention.' that was published in Vaccine in 2008.

Excerpt reads..........

PNG and other countries in the Oceania region have limited resources and do not have the same capacity for funding preventive health initiatives, such as systematic surveillance for cervical cancer or dysplasia.

The only radiotherapy facility in PapuaNewGuinea has been out of service since 1997. Asmost cancers present past stage one, cancer of the cervix puts a significant burden on the women themselves and the already overstretched gynaecological services. Palliative care is also very difficult with morphone being in short supply, especially oral formulations.

About 20,000 Pap smears were taken between 2002 and 2006. Pap screening is undertaken in family planning clinics, well-women’s clinics, public gynaecology clinics, private medical practice, and in church agency district hospitals and health centres.

There is limited availability of Pap screening in rural areas. About 80% of the smears taken are read in Sydney by a professional cytologist at Meripath, while the remaining 20% are read locally by a histopathologist at the Port Moresby General Hospital as there is no in-country person trained in cytology.

About 50% of women who have had a Pap smear, it was their first (or only) smear. Only about 4.7% women in PNG have had a smear at least once in their lifetime. The number of women having regular 2–3 yearly smears is much fewer. Meripath figures for 2006 show that, of the 14,800 smears examined, 1057 (7.1%) were abnormal, 674 had low-grade abnormalities (4.6%), and 351 (2.4%) had high-grade abnormalities.

There are virtually no colposcopic services in PNG in the public sector. Pap smear abnormalities are usually managed by repeat smear, cone biopsy or hysterectomy. In many places where there are no postal addresses or telephone contacts it can be difficult to findwomenwhohave been found to have Pap smear abnormalities.

..................excerpt ends.

In 2008, Dr. Mola stated that the cancers diagnosed from Port Moresby are generally in youngerwomen, and more than 50% being under the age of 35 years

As of April 2009, the anti-cervical cancer vaccine, Gardasil, is now available to girls and women aged between nine and 26 in Papua New Guinea. However, the private Pacific International Hospital in Port Moresby is the onely one offering the vaccine against the country’s number one cancer that kills 3- and a half thousand women each year. The hospital’s head of obstetrics and gynecology, Dr Mathias Sapuri, says they have to charge 280 US dollars (around K830) for each of the required three doses.

What about the rest of PNG women who do not earn that amount of money let alone have enough to buy the doses? Do they just die from this most preventable disease?

We have to start a national Prevention Program that looks at health policy, priority funding, reorientating government health services, research etc. Even just a kick start fund of K30 million can go a long, long way in helping women and girls of this country avoid this most preventable disease.

Sources
Garland, S. M., J. M. L. Brotherton, S. R. Skinner, M. Pitts, M. Saville, G. Mola, and R. W. Jones. 2008. Human Papillomavirus and Cervical Cancer in Australasia and Oceania: Risk-factors, Epidemiology and Prevention. Vaccine 26 (Supplement 12): M80-M88. http://www.sciencedirect.com/science/article/B6TD4-4TD5VXV-F/2/828e86c863ef7b252724683444ca05de (accessed 19 May 2010).

Parkin DM, Freddie Bray, Ferlay J, Pisani P. Global Cancer Statistics, 2002. CA Cancer J Clin 2005;55:74–108.

Radio New Zealand International Anti-cervical cancer vaccine available in PNG at hefty fee: http://www.rnzi.com/pages/news.php?op=read&id=45830

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