Press Release – Presentation by Minister of Health Hon. Dr. Frank Anthony for the London Global Cancer Week

Presentation by Minister of Health Hon. Dr. Frank Anthony

For the London Global Cancer Week

Commonwealth Collective Action on Cancer Prevention

Cervical Cancer: Lessons and Opportunities

November 19, 2020

Excellencies, distinguished ladies and gentlemen, wherever you are in the Commonwealth, good morning, good day, good afternoon.

Allow me to thank the Rt. Hon. Patricia Scotland, Secretary-General of the Commonwealth and all those involved in organising the London Global Cancer Week, Commonwealth Collective Action on Cancer Prevention – Cervical Cancer, Lessons and Opportunities.

Background

The World Health Organization has ranked cervical cancer as the 4th most common cancer among women globally, with an estimated 570,000 new cases in 2018. Nearly 90 per cent

of the 311,000 deaths worldwide in 2018 occurred in low middle-income countries.

In the Caribbean, cervical cancer is the second cause of cancer deaths among women. The estimated 2012 age-standardised incidence rate of cervical cancer for the Caribbean is 23.6 per 100,000 women per year, while that for the Americas is 17.2 per 100,000.

Cervical cancer in Guyana is the second most common cancer, with an average annual incidence rate of 46.9 per 100,000 population.

• Two thirds of all cases are in women below the age of 60 years.
• The 15-39 years age group has the highest percentage of cervical cancer.
• The average annual mortality from cervical cancer is 27 per 100,000.

Our cervical cancer programme consists of primary, secondary and tertiary prevention.

Primary prevention

In primary prevention, our main focus was the introduction of the HPV Vaccination. In Guyana, HPV vaccines were first introduced in 2012, with a donation of 6,600 doses from the International Planned Parenthood Federation.

The programme encountered tremendous push back from anti-vax campaigners, where some compared the programme to the Tuskegee Trails in the USA. The programme came to a temporary halt in 2014.

In 2016, with the assistance GAVI, Guyana received support for the continuation of the HPV Vaccination programme, and the programme was re-launched in 2017.

With the relaunch of the programme, uptake has gone to 31 per cent for first dose and about 13 per cent for the second dose. So there is plenty of work to be done to expand the programme to achieve 90 per cent by 2030. We think it would be useful if there can be a Commonwealth Communication programme to encourage parents to allow their children to vaccinate with HPV.

Secondary prevention

Our focus has been on screening of women 30 years and older. Unfortunately, we do not have a comprehensive screening programme.

In 2008, PEPFAR introduced the use of visual inspection of the cervix using acetic acid for HIV positive women. The programme started to pilot at five treatment sites in Guyana.

In 2010, the pilot was scaled up from five to twelve sites, and was open to all women, 30 years and above.

In 2019 the programme was offered at 22 sites. Unfortunately, the uptake of VIA screening has declined.

Tertiary prevention

Access to diagnosis, cancer surgery, radiotherapy, medical oncology and palliative care is limited to a few hospitals in the public and private sectors. Statistics on cancer surgeries are not readily collected. Radiotherapy is offered in one private facility. The Government of Guyana provides co-financing or subsidies for patients in the public sector.

New directors for 2021 to 2030

As part of the new strategy, legislation and regulation governing radiation medicine would be developed and implemented. Quality and range of services must be improved and decentralised. Efforts will be made to improve access, availability, and quality of drugs specific to cancer and supportive care.

A few non-governmental organisations offer limited palliative care.

Guyana is committed to working on the reduction and possible elimination of cervical cancer by 2030. We have committed to developing a new cervical cancer prevention strategy and plan which should get us closer to the World Health Organisation targets of 90 per cent vaccination 70 per cent screening and 90 per cent treatment by 2030.

Once again, allow me to thank the Commonwealth countries for sharing their experiences, and we look forward to working with you, as we strive to provide comprehensive cancer care for our citizens.

Thank you.

For more information on this event, please click link below:

https://thecommonwealth.org/media/event/join-commonwealth-during-london-global-cancer-week