Cervical Cancer and Its Impact on the Burden of Disease
Case Study #3-14 of the Program: ''Food Policy For Developing Countries: The Role Of Government In The Global Food System''
Napolitano, Michael; Schonman, Erica; Mpango, Elisia; Isdori, Gabriel
Although cervical cancer is no longer a major issue in developed countries, it is still a serious concern in developing countries such as Tanzania, where the prevalence continues to rise. Cervical cancer causes more deaths among Tanzanian women than any other form of cancer. This trend, which is also observed in other developing countries, is not occurring in developed countries; this difference suggests that it is feasible to reduce the incidence of cervical cancer in Tanzania. When considering the issue of cervical cancer in Tanzania, it is important to understand the underlying causes and the severe negative outcomes. Certain risk factors make women more likely to develop the disease. These include multiparity (having multiple births) and sexually transmitted infections such as HIV and human papilloma virus (HPV), which increase the sensitivity and regeneration of cervical cells. If not treated, cervical cancer is fatal. The consequences of losing a mother are devastating for a family, but even when the disease is not fatal, the consequences are severe. Surgical and radiological treatment of cervical cancer often leads to physical, psychological, and sexual issues, as well as infertility. These debilitating outcomes warrant policies to reduce the prevalence of cervical cancer in Tanzania. Once the cells of the cervix become malignant, it is important to identify the malignancy early to prevent mortality and reduce morbidity. Because cervical cancer is asymptomatic until its advanced stages, the only way to diagnose cervical cancer early is by screening women regularly. In developed countries, the Pap smear test is a common and widespread method that is effective in identifying malignancy; however, it is an expensive option that is not practical in low-income countries. The World Health Organization (WHO) has recently attempted to promote a cheap and effective screening option called visual inspection by acetic acid, or VIA, but the method is not yet in widespread use. Stakeholders such as the WHO and the International Agency for Research on Cancer (IARC) have been at the forefront of cervical cancer prevention and treatment in Tanzania and other developing countries, but more aid is needed. Other stakeholders such as the media, patients, women at risk, and health systems and hospitals are important to consider, but they have little influence. By providing more funding and resources for education and a VIA screening program, the Tanzanian government could inexpensively decrease cervical cancer while simultaneously improving maternal health, a Millennium Development Goal that is not currently on track to be accomplished by Tanzania. A cost-effective program would make Tanzania a pioneer among developing countries, and could even catch the attention of developed countries and further accelerate Tanzania's climb out of poverty. Policy options should aim to combat the factors that contribute to the high incidence of cervical cancer in Tanzania. Young women and the general public seem poorly informed about the risks and severe consequences of cervical cancer. Any policy should therefore include efforts to educate these groups. Barriers to extensive Pap smear screening stem mainly from the high cost of such a procedure, so implementing a policy that includes the cheaper VIA test should be considered. Your assignment is to compel the Ministry of Health of Tanzania to implement a low-cost and effective program that will reduce the negative impact of cervical cancer, keeping in mind the stakeholders in this issue, their available resources, and their interests.
16 pp.©Cornell University, Ithaca, New York. All rights reserved. This case study may be reproduced for educational purposes without express permission but must include acknowledgment to Cornell University. No commercial use is permitted without permission.
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Previously Published As
Michael Napolitano, Erica Schonman, Elisia Mpango, Gabriel Isdori (2012). Case Study #3-14, ''Cervical Cancer and Its Impact on the Burden of Disease''. In: Per Pinstrup-Andersen and Fuzhi Cheng (editors), ''Food Policy for Developing Countries: Case Studies.''16 pp.