Cervical of public health concern world- wide.

Cervical cancer screening is the process of
detecting and removing abnormal tissues or cells in the cervix before cervical
cancer develops (Globacon, 2012).Cervical cancer is a disease of public health
concern world- wide. It is the second leading cause of female cancer in Nigeria
and most common in women aged 15 to 44years (WHO, 2017). Recently, worldwide,
approximately 500,000 new cases of cervical cancer and 274,000 deaths are
attributable to cervical cancer yearly, making cervical cancer the second most
common cause of death from cancer in women (WHO, 2016). Fortunately, the
incidence of cervical cancer has decreased by more than 50% in the past 30+
years, largely due to the increasing use of cervical cancer screening with
cervical cytology (WHO, 2016). The aetiological agent is the human papilloma
that is sexually transmitted. The cervical cancer incidence is related to
lifestyle, poverty and sexual practices. However, it is a preventable disease
as it is preceded by pre-invasive phase that can be detected and treated.By
aiming to detect and treat cervical neoplasia early on. Cervical cancer
screening aims at secondary prevention of cervical cancer(WHO, 2015).It is
relatively inexpensive and there is worldwide agreement that screening
programmes for cervical cancer are a necessity (Ngoma, 2009). This preventable
cancer has a long precancerous stage, however, the virus survives for years,
contributing to the process that causes some cells on the surface of the cervix
to become cancer cells and during this interval, screening could be done, and
any precancerous lesions identified could be adequately treated to prevent
progression to the invasive cancer stage (Castilaw & Wittet, 2010).
Effective interventions against cervical cancer exist, including screening and
treatment. Screening aims at detecting infection with human papilloma virus
precancerous cells. An estimated 96% of women in developing countries have
never been screened for cervical cancer and 80% of women newly diagnosed with
cervical cancer live in developing countries; mostly diagnosed when they have
advanced disease (WHO Fact sheet, 2016).

The first
screening test to be widely used for cancer was the Pap test. The test was
developed by George Papanicolaou as a research method in understanding the
menstrual cycle. Papanicolaou soon recognized its potential for finding cervical cancer early and presented his findings in 1923. At first,
most doctors were sceptical, and it was not until the American Cancer Society
(ACS) promoted the test during the early 1960s that this test became widely
used. Since that time, the cervical cancer death rate in the United States has
declined by about 70% (AGOG,2009).A variety of screening tests have therefore
been developed in an attempt to overcome the innate limitations of conventional
cytology (Davey et al., 2007).

The mainstay of cervical cancer screening for the
last 60+ years has been the Papanicolaou test. The Papanicolaou test, also
known as the Pap test or the Pap smear, was developed in the 1940s by
GeorgiosPapanikolaou. It involves exfoliating cells from the transformation
zone of the cervix to enable examination of these cells microscopically for
detection cancerous or precancerous lesions. Other screening tests that
are cost effective to complement pap smear include liquid based cytology,
liquid based pap test such as SurePath and Thinprep. Then, Visual inspection
with Acetic acid (VIA) or Lugol’s Iodine and HPV testing.


Cervical cancer is on the increase in spite of
government efforts to contain it. People are negatively affected because of
inadequate information concerning the signs and symptoms of cervical cancer and
lack of screening exercises in Nigeria. Although in developed countries
cervical cancer rates have decreased dramatically due to the increase in
adequate information and awareness of the health implications of cervical
cancer and screening efforts. However, the incidence and prevalence in
developing countries remains high due to lack of screening programs and
inadequate information, with approximately 80% of all cervical cancer deaths
occurring in the developing world (WHO, 2016). Screening programmes in Africa
are however often rudimentary or non-existent. In addition, there was a report
indicating the annual cervical cancer cases in Nigeria as 14,089 and the annual
number of cervical cancer death as 8240(WHO, 2014). This reported high
incidence is a public health issue and demands aggressive health intervention
in order to avoid the morbidities and mortalities associated with cervical

radiotherapy unit  of Ahmadu Bello
University opened in 1996 has treated over 4000 cases of cervical cancer out of
a total of 5708 gynaecological cancer. Cervical cancer constituted over 60% of
histologically confirmed cancer cases among women in a 10-year review from


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