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概要

A Review of Cervical Cancer in South Africa: Previous, Current and Future

Jordaan S1*, Michelow P, Richter K, Simoens C and Bogers J

Cervical cancer is the second most common cancer in South African women. Opportunistic screening for cervical cancer has been available for the last five decades. In 2000, the South African Department of Health launched a national cervical screening programme. However, this has not been fully implemented. South Africa has the largest expanding HIV burden in the world and it is estimated that 5.7 million South Africans are currently living with HIV/AIDS, of whom 60% are women. The high prevalence of HIV complicates the situation as HIV-infected women have greater rates of pre-invasive and invasive cervical cancer rates whereas HPV infection promotes the acquisition of HIV. In April 2011 the South African government launched the HIV Counseling and Testing (HCT) campaign, a new national drive to encourage people to know their HIV status and access counseling and treatment including cervical screening. In April 2014 the South African National Department of Health implemented a school-based HPV vaccination program for all girls 9 years and older, in grade 4. The rollout targeted 450 000 girls in 17 000 public schools. However, the reduction of cervical cancer and its precursor lesions due to HPV vaccination will only be realized in the coming decades. Thus screening for, and management of both pre-invasive and invasive cervical cancer needs to be enhanced. The South African National Department of Health will soon announce and implement a new cervical cancer control policy. This review discusses the history of cervical cancer in South Africa, current prevention strategies and suggestions for an improved cervical screening programme.