Reducing The Number Of Women Dying Of Cervical Cancer In Papua New Guinea And The Pacific; What Are Our Options?

Cervical cancer is the second commonest cancer among women of reproductive age group in PNG. In 2002 there were 200 new cases reported at the Port Moresby General Hospital. And the incidence is rising. There have been much publicity about this increasing incidence and the need to do reduce it, but there has been a lack of concerted effort to do something about it. A document has also not been prepared to clearly outline the measures that will and need be taken to reduce the number of women dying of cervical cancer each year. I would like to give my suggestions and they are; education and awareness, screening program, surgery with or without radiotherapy, and palliative care for terminal cases.

Education and Awareness

I think educating and making women in the reproductive age group aware of what cervical cancer is, the signs and symptoms of cervical cancer, and what the risk factors are is the only way for reducing the high mortality rate in developing countries in the abscence of a national Pap smear screening program. There are many ways on how we can go about implementing the education and awareness programs.

The programs can be incorporated into existing education and awareness programs for maternal and child health (e.g. MCH clinics, ANC clinics), programs for STIs, (e.g. STI clinics), building it into senior high school curriculums (as part of sexual education), or any other programs that I may have not included. This will ensure women having very basic knowledge about cervical cancer from high school to be more familiar with cervical cancer when attending health talks before the beginning of a clinic, say a MCH clinic. Also the repetition of the same message reinforces what they already know and builds on the basic knowledge.

Early Surgery and Radiotherapy

Early surgery is possible if presentation is early. This makes the education and awareness of the early possible signs and symptoms of cervical cancer more important. The Women Doctors Association of PNG have been very vocal on the issue and thanks to their dedication the government has finally listened and budgeted for the radiotherapy unit in ANGAU hospital in Lae to be revived.

Pap Smear Screening Program

National Pap smear screening programs has dramatically reduced the mortality caused by cervical cancer dramatically in developed countries. However, in countries like PNG (and other pacific island countries) many people may think that Pap smear in a developing country may not be cost-effective.  Some of the reasons may be that we think a national program for Pap smear test would need a lot of funding, and this is probably true. The initial cost of establishing the infrastructure, the network and training of human resources in itself may cost a lot more even before the program is launched. However experience in other developing countries like Vietnam has shown that a national Pap smear program in developing countries can be cost-effective (less than US$ 0.092 per woman) provided there is external assistance for training of human resources to screen Pap smear slides.

Palliative Care

Finally, if nothing else can be done, than I think at least all effort must be made to ensure women with terminal cervical cancer are properly taken of in hospitals. Palliative care is an area that needs to be improved a lot in PNG, especially pain management, so that women who have terminal stage cervical cancer can die peacefully with dignitity as human beings. The visit by Dr Neill Muirden from the International Association for Hospice and Palliative Care in 2001 increased the awareness of cancer and pain management. The onus is now up to us to take it from there do something about it.


About rodney itaki

Medical doctor and public health specialist from Papua New Guinea.
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14 Responses to Reducing The Number Of Women Dying Of Cervical Cancer In Papua New Guinea And The Pacific; What Are Our Options?

  1. My Kids View says:

    This is very nice and informative post. I have bookmarked your site in order to find out your post in the future.

  2. Susina says:

    This is a very interesting topic and I hope there should have more evidence based research on this. There is a prevelence of this disease in our country & I believe more awareness and health promotion should be out there for the public.
    Futhermore, I am interested to know more if you are aware of any latest infomation.

    Thankyou and keep up the good work!!!

    Susina Yatapya

    BA Midwife Student

  3. jaive says:

    I enjoyed this post. Can I do an article on it and share on for PNG Moms

  4. Loujaya Toni says:

    I am a Masters Student at the University of Technology working quietly but steadily on releasing my dissertation on an alternative low cost organic cancer treatment for Papua New Guinea women.
    From 2005 since I registered my fieldwork as Vital Link Health I have been collecting data and carrying out awareness in rural Papua New Guinea at my own cost and interest.
    This year I enrolled at UNITECH to strengthen my work through research in the field of medical sociology. I am sure many of you will be pleasantly suprised how a non-science student can create a formula that will be patented as Papua New Guinean after the acceptance of my dissertation for saving of ALL PAPUA NEW GUINEA WOMEN who have cancer ,now only a select few have been trained by me and are working at own cost within rural PNG communities. Kind regards and GOD of ISRAEL gets the glory!

    • rodney itaki says:

      You can submit your paper for publication to this journal if you are interested. Its good to get critical review on your scientific work. Good luck.

    • Jacqui says:

      Hi my name is Jacqui and I am from Milne Bay, I am interested in getting in touch with you as we hve something in common as to give hope and make a difference for the women of PNG, I have had three operations for cervical cancer and am adiment to help other women not only at home in PNG but in other Pacific countries. I am after studies in regards to Cervical Cancer for PNG as I am venturing to set up a foundation to assist women diagnosed with this cancer to have help to treat this problem.

      I look forward to hearing from you at the soonest.



  5. Matthew.M. David Health Extension Officer says:

    Extensive activity (such as immunisation actvity in PNG) must be implemented in early detection and treatment.One cost effective measure (apart from Pap Smear) is PV Examination on all women (menarche to post-menopausal) who presented with LAP (Lower Abdominal Pain).
    Health workers must perform this procedure to check the status of the cervix and refer or advice problem mothers accordingly.

  6. Esther Caroline McKay-Glambi says:

    Hi all.
    My name is Adasha E. McKay. I am currently taking up MPH Monash University, VIC AU. Cervical cancer is one of my topics for assessment task as I am interested in acquiring all available information to try help our rural women experiencing poor or less access to well-women health services.
    Loujaya Toni, are you the woman who got elected as MP? If so, congratulations! If you do cruise around this blog, I surely would like a copy of the dissertation you were working on (an alternative low cost organic cancer treatment for Papua New Guinea women).

    Thanks again

    Adah (sumatin)

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