Cervical Cancer in Ghana: Why Screening Saves Lives

 

Cervical Cancer in Ghana: Why Screening Saves Lives and How to Access It

Cervical cancer is the second most common cancer among Ghanaian women and one of the leading causes of cancer death in women across sub-Saharan Africa. What makes this particularly devastating is that cervical cancer is one of the most preventable and, when caught early, one of the most treatable cancers that exists. It has a long pre-cancerous phase of years to decades before it becomes invasive, during which screening can detect and treat abnormalities before cancer develops. And there is a vaccine that prevents the virus that causes it. Yet women in Ghana continue to die from it — primarily because screening rates are low and the majority of cases are diagnosed at an advanced stage.

The Role of HPV

Virtually all cervical cancers — over 99% — are caused by persistent infection with certain strains of the Human Papillomavirus (HPV). HPV is an extremely common sexually transmitted virus; most sexually active people are infected at some point in their lives. The majority of HPV infections are cleared by the immune system without causing any harm. However, certain 'high-risk' strains — particularly HPV 16 and 18, which together cause approximately 70% of cervical cancers — can persist and, over years, cause cellular changes in the cervix that progress from mild abnormalities (dysplasia) to invasive cancer if left undetected and untreated.

Understanding Cervical Screening

Pap Smear (Pap Test)

The Pap smear involves collecting cells from the surface of the cervix using a small brush or spatula, smearing them onto a glass slide, and examining them under a microscope for abnormal cells. It detects cervical cell changes (dysplasia) before they become cancerous. The test is quick, involves mild discomfort rather than pain when properly performed, and has transformed cervical cancer outcomes in countries where it is widely used. Ghana's health system offers Pap smear services at most regional and some district hospitals, and at many reproductive health clinics.

HPV DNA Testing

A more sensitive alternative or complement to the Pap smear. Rather than looking for abnormal cells, HPV DNA testing detects the presence of high-risk HPV strains directly. A positive result does not mean you have cancer — it means the virus that can cause cancer is present, and that closer monitoring or colposcopy is warranted. HPV DNA testing is increasingly available in Ghana at private laboratories and selected government facilities.

Visual Inspection with Acetic Acid (VIA)

A practical, affordable screening method particularly suited to resource-limited settings. A solution of dilute acetic acid (white vinegar) is applied to the cervix — abnormal cells turn white (acetowhite), allowing visual identification without laboratory equipment or microscopy. VIA has good sensitivity for detecting high-grade lesions and can be performed by trained nurses at the community level. The treatment (cryotherapy or thermal ablation) can be applied at the same visit — a 'screen and treat' approach that reduces loss to follow-up. VIA is the primary cervical screening method at many health centres and polyclinics in Ghana.

What Cervical Screening Recommendations Apply to Ghanaian Women

• Age 25–65: Pap smear every 3 years, or HPV DNA test every 5 years, or VIA every 3 years

• HIV-positive women: Screening should begin at HIV diagnosis and be performed every 1–2 years regardless of age

• Women who have had an abnormal result: Follow-up is individually determined based on the finding

• Women who have been vaccinated against HPV: Vaccination reduces but does not eliminate risk — screening should continue

The HPV Vaccine

The HPV vaccine is one of the most powerful cancer prevention tools in medicine. It protects against the HPV strains responsible for approximately 70–90% of cervical cancers. The vaccine is most effective when given before sexual debut — typically ages 9–14 — but provides benefit up to age 26 and in some cases beyond. Ghana introduced the HPV vaccine into its national immunisation programme for adolescent girls. If you have a daughter between 9 and 14 who has not yet been vaccinated, make it a priority.

Barriers to Screening in Ghana and How to Overcome Them

Stigma and Embarrassment

Many women avoid cervical screening due to embarrassment about the examination, or cultural discomfort with discussions of reproductive health. Understanding that cervical screening is a standard, brief medical procedure — no different in principle from any other health check — is the first step. Requesting a female clinician where possible can ease discomfort.

Misconceptions

Some women believe that if they have no symptoms, they do not need screening. This fundamentally misunderstands how cervical cancer works — dysplasia and early invasive cancer cause no symptoms. By the time symptoms appear (abnormal bleeding, pelvic pain, discharge), the cancer is often at an advanced stage.

Distance and Cost

VIA screening at government facilities is available at minimal or no cost under NHIS for eligible women. Multiple NGOs and reproductive health organisations in Ghana conduct periodic free cervical cancer screening outreach programmes. Ghana Health Service and organisations such as the Pink Ladies Foundation run awareness campaigns and screening drives that provide free services.

�� Every woman in Ghana between 25 and 65 should have a cervical screen. It is quick, available, often free, and can save your life. Make the appointment this week.