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Some 33 women residents of Tondo, Manila were screened for cervical cancer, for free, during the scheduled July 30 "WHEELS CAN CERV" Cervical Cancer Screening Caravan, conducted recently by the IWC Central Makati, District 383 in the Philippines. The screening activity is one of many more lined up in several areas of the Philippines, as a vital component of the Club’s Cervical Awareness Program for the past two years.
The women of Tondo, residents of one of the poorer quarters of the country’s National Capital Region, are among 50 women initially scheduled for the day. However, due to the persistent two-week monsoon rains that threatened street flooding, 17 women were unable to leave their homes. A new screening schedule will be set for them after the lifting of the current Covid-19 ECQ lockdown of Metro Manila.
Many of the 33 screened women expressed relief of finally learning if they were harbouring any HPV virus that causes the dreaded cervical cancer. Yet, seven (7) of them, or 21.21%, were found to be positive of the cancer-causing HPV virus. One lady was immediately referred for biopsy, while the rest were requested to come back for rescreening in 3-months- time.
Cervical Cancer can be prevented with both vaccination and early regular cervical screening (further reading below).
The cost of both the HPV Vaccine and the available Cervical Testing/ Screening Procedures in the Philippines are way beyond the reach of 90% of families in the Philippines. A dose of the HPV vaccine is equivalent to two-week’s salary of a regular worker, while a cervical screening costs an average equivalent to one-week salary. No wonder that most cases ae detected only in the 3rd and 4th stages of cervical cancer when medical and cure become extremely expensive.
The July 30 "Wheels can Cerv" Cervical Cancer Screening Caravan is a valuable opportunity for low-income women to detect any potential cancer cells ahead. The project is among the many partnerships of Inner Wheel Club of Central Makati with CerviQ, a social enterprise focused on the elimination of cervical cancer in the Philippines. CerviQ pioneered the use of AI-assisted VIA Colposcopy cervical screening in the country earlier this year. Developed in Korea, the technology assures cervical screening results with +93% accuracy, within 5 minutes. This very same procedure is used in the "Wheels Can Cerv" Caravans, thus the women immediately know if they have normal cervical cells or have HPV requiring treatment or biopsy.
IWC Central Makati was joined by several Inner Wheel District 383 sister clubs--IWC Makati, IWC of Makati North, IWC Makati, San Antonio, IWC Taguig, IWC Paranaque--and IWC Marilao of District 377, which sponsored the cost of free screening for this first batch of women recipients. Succeeding Caravans will be fully supported by all clubs of District 383 and hopefully by many more all over the country.
Two (2) Rotary Clubs, RC Manila Kalaw and RC Manila South of District 3810, also provided funds for the free screening services. Due to the Covid-19 pandemic lockdown, not all clubs were allowed to send their representatives to join the activity physically. The office of Barangay 187 Zone 17 in Tondo in Manila offered the free use of the Barangay Hall for the cervical screening.
Partnerships with health workers, clinics, laboratories, government support and donors are critical to even visualize the dream to eliminate cervical cancer by year 2050. The goal is daunting but achievable, if many more women help each other to help other women.
The "WHEELS CAN CERV" Cervical Cancer Awareness Program of IWC Central Makati was initiated in early 2019 and continues to evolve into a multi-dimensional nationwide organizational campaign to help millions of Filipino women better understand their responsibility in preventing the only preventable cancer, with support of NGOs, media, government and its functionaries.
To date, half a dozen online “Wheels Can Cerv” seminars and discussions have been held for middle class women who can learn and help pass on the word, orientation and training of komadronas (midwives on whom many low-income women are dependent on) to conduct cervical screening, as well as sharing knowledge with military personnel, both men and women. Leading oncologist Dr Jesus Randy Rivera conducts most of the lively trainings.
Cervical Screening Caravans all over the country are coordinated with the local governments, and partner groups in each area. Clinics and health centers have been contacted and enjoined to provide lower-priced services for cervical screening and HPV vaccination. A program designed for abused women and girls, and other sectors of women vulnerable to cervical cancer, is now in the pipeline. An extensive multi-media campaign will soon to be launched.
IWC Central Makati is one of the younger clubs of IWCPI District 383. Chartered on August 21, 2018, the club has since made waves in the areas of childcare and welfare, educational scholarship, opportunities and care for the differently-abled and the cancer-stricken members of society, as well as Operation Paglingap (Disaster Relief Operations).
Cervical cancer is the second deadliest cancer among women in the Philippines. The cancer is caused by the human papillomavirus, commonly known as HPV, usually acquired through sexual transmission, which lodges in the cervix (that 2cm x 4cm tissue located at the lower end of the uterus). Unfortunately, symptoms such as unusual vaginal bleeding, discharge and pain, will only appear at the 3rd or 4th stages of cervical cancer.
Perhaps due to the location of the cervix in a woman's body, only a small percentage of women would talk about, or consider the possibility of early screening, resulting in a startling figure of 11 women succumbing to cervical cancer daily in the Philippines. (Department of Health, Philippines, 2018 estimates)
But, cervical cancer is the only cancer that is preventable and curable. It can be prevented with early vaccination, and curable with early detection through screening
Early vaccination. Experts advise 2 doses of the HPV vaccine for girls aged 9-14 years old, and 3 doses for girls and women aged 15 to 45 years. Because the HPV virus can also lead to other types of cancers in the genital area of both sexes, boys and men are also encouraged to be vaccinated early.
Regular Screening. Another way to prevent the HPV virus from entering and wreaking havoc in women's bodies is Cervical Cancer Testing or Screening. All women between the ages of 25 and 65 years are encouraged to get tested every 3 to 5 years for early detection and prevention. When necessary, effective medication and cure will then be less costly. The World Health Organization (WHO) reports that women between 30 to 49-years-old, whether they have undergone cervical screening or not, and those who are between 50 to 60-years-old who have never had any previous screening, are considered "high risk" for cervical cancer.
Three types of cervical screening tests or procedures are available. The first and the mainstay cervical cancer screening for the last 60 years is the Paps Smear. The OB-Gyne collects cells from the cervix which is then interpreted by a cytopathologist.
The second type of cervical screening, the VIA or Visual Inspection with Acetic acid, involves the application of 3-5% acetic acid on the cervix to visually check the cell changes that can develop into cancer. However, the lack of standardized reading from VIA, and a wide range of visual variables can lead high false positive results.
The third and more effective cervical screening procedure is the HPV DNA Test which detects the presence of HPV that can cause cell changes in the cervix. When results are normal, the doctor may advise for a subsequent screening within 5 years with a high-performance test. Unfortunately, HPV DNA testing is quite expensive and as yet not available in the country.
When abnormal cells are detected in any of these three types of cervical cancer screening tests, the doctor may recommend a further diagnostic procedure called Colposcopy, with an instrument called a colposcope. Newer and upcoming technology breakthroughs are now underway to combine the second type of cervical testing, VIA, with Colposcopy. Combined with AI (artificial intelligence or technology), this eases diagnosis and same-day treatment of patients with cervical pre-cancer and those requiring biopsy.