Ending Cervical Cancer: Strengthening Prevention, Awareness, and Community Efforts

Cervical cancer remains one of the most preventable cancers, yet it continues to pose a significant health threat to women in Uganda.

Dr. Carolyn Nakisige, a gynecologist at the Uganda Cancer Institute, is leading efforts to shift the focus from treatment to prevention.

“Unlike many other cancers, cervical cancer has a long natural history,” says Dr. Nakisige. “From the time someone is infected with the virus to when they develop the disease, we have about 10 to 20 years. This gives us a golden opportunity to intercept and prevent it.”

One of the most effective prevention strategies is the HPV vaccine, recommended for girls at 10 years old.

However, vaccination efforts have faced challenges, particularly in administering the second dose.

“Our biggest challenge came with the second dose. We saw a drop, and when we investigated, myths and misinformation were a major factor,” explains Dr. Nakisige. “People believed we were sterilizing their daughters.”

To counter this, health authorities are intensifying awareness campaigns targeting parents, local leaders, and fathers. “Fathers are very influential in these decisions, and engaging them is key,” she adds. “The good news is that WHO now recommends a single-dose vaccine, making coverage easier.”

Screening, another crucial pillar of prevention, faces obstacles such as discomfort and lack of privacy at health centers.

“Our main method, visual inspection with acetic acid, requires women to undress, which many find uncomfortable. And because they don’t feel sick, they see no urgency,” Dr. Nakisige says.

To bridge this gap, the Spark Project, led by Shamim Namagembe of the Uganda Rural Development and Training Program (URDT), is working to expand screening in rural areas, particularly in Bunyoro, including Kagadi and Kakumiro districts.

“The project aims to make these services accessible even to women in the deepest villages so they can get information and make informed decisions about screening,” says Namagembe. “One of our biggest innovations is working with social workers. In previous projects, we faced domestic violence issues when women screened without consulting their husbands. Now, social workers help mediate and explain the process to families.”

Since its inception in 2024, the Screening Project for Advancing Cervical Cancer Awareness and Detection (SPACC Project) has screened 8,600 women through community outreaches and health facilities. “Of these, 690 women required further medical intervention,” she notes.

Dennis Olodi, Executive Director of the Uganda Cancer Society, emphasizes the need to involve cultural and religious leaders in cervical cancer awareness efforts.

“Uganda is a highly rural society with a conservative population. Community pillars such as traditional leaders play a crucial role in holding families together. People trust them for wisdom and guidance,” Olodi explains.

“Similarly, religious leaders have strong influence over moral and health decisions. We must bring them on board.”

The media, too, has a vital role. “Journalists are not just information disseminators; they can be newsroom advocates. We need to document and share stories of cancer survivors and patients. This will not only inspire hope but also encourage more women to seek preventive services,” he adds.

Despite these efforts, funding remains a pressing issue, particularly following the UK government’s recent review of its aid contributions.

“In the face of funding constraints, we must foster collaboration,” Olodi says. “If the Uganda Cancer Institute can handle one aspect but lacks the capacity for another, and the Uganda Cancer Society can fill that gap, we must work together.”

He also calls for local fundraising efforts, citing the success of Rotary’s Cancer Run. “When it started in 2012, they raised Shs 200 million. By 2013, it was Shs 300 million, and in 2023, they raised Shs 243 million. This proves that with the right message and engagement, local efforts can yield tangible results.”

Dr. Nakisige remains optimistic that Uganda can significantly reduce cervical cancer cases through continued awareness, vaccination, and screening efforts.

“We are identifying barriers and addressing them. The turning point is prevention. The more we focus on that, the fewer lives we will lose,” she concludes.

With enhanced community involvement, stronger policies, and collective action, Uganda is well on its way to turning the tide against cervical cancer.