Cervical Cancer Screening
See and Treat Clinic
Little is known about rates of HPV/cervical cancer in Sierra Leone. Estimates of cervical cancer rates/deaths are limited by lack of data. In 2014, the WHO found cervical cancer to be the leading cause of cancer mortality among women. In 2018, cervical cancer accounted for 8.1% of all reported cancer deaths, despite only accounting for 7.2% of all reported cancer incidences. There is no knowledge of the rates of HPV infection in Sierra Leone, as testing for the virus is mostly unavailable in the country. However, the HPV information center reports a general prevalence of 4.3% of high-risk HPV strains among women in the West Africa region.
Elimination of Cervical cancer is a global initiative. However, in Sierra Leone there is no established screening program, nor an active HPV vaccine program. These limitations mean little to no progress on decreasing rates of cervical cancer in the country.
City Garden Clinic in Makeni, under the guidance of Dr. Erdi Huizenga and with the support of Smarter Hospital Foundation, began a pilot See and Treat program in 2019, using Visual Inspection with Acetic Acid (VIA) and thermal ablation therapy.
In February 2021, PIH Health’s Dr. Sacha Kang Chou joined the FM residency trop med team to help jumpstart the See and Treat cervical cancer screening program. City Garden Clinic made an announcement on the “Good Morning Salone” radio program to offer free cervical cancer screening for 1 week to women ages 25-64.
During this week, the hospital was able to screen 225 women, hailing from Makeni, Yele, Freetown, and other cities. Of the 225 women, approximately 30% of women had positive screenings and were treated onsite. Four cases of severe dysplasia/overt cervical cancer were found; one of which was subsequently admitted to the hospital and successfully received a hysterectomy.
It is our aim to be able to continue the work begun by Dr. Erdi implementing cervical cancer screening in Makeni. With the PIH Health Family Medicine Residency program making regular trips to Makeni, we hope to continue hosting a static program during the time PIH Health residents are volunteering. Program champions, the hospital Matron and one of the Clinical Health Officers, have been extensively trained. Further expansion will be driven by City Garden Clinic and Smarter Hospital, as more staff become more comfortable with performing the screenings/treatment independently.