Transforming Cervical Cancer Care: A Call for Education and Innovation

Insights from Professor Rose Ihuoma Anorlu

Cervical cancer remains a pressing global health challenge, particularly in low- and middle-income countries (LMICs) where disparities in prevention, screening, and treatment persist. To gain deeper insights into the current state of cervical cancer care and the path forward, the Society for Translational Oncology (STO) had the privilege of interviewing Professor Rose Ihuoma Anorlu, MBChB, MPH, MD, FMCOG, FWACS, FRCOG.

Professor Anorlu, a distinguished expert in Obstetrics and Gynecology based in Nigeria, has dedicated her career to advancing cervical cancer prevention and treatment. As a Professor at the University of Lagos and an Honorary Consultant at Lagos University Teaching Hospital, her contributions span teaching, research, and clinical practice. With over 120 peer-reviewed publications, leadership roles, and a history of training thousands of healthcare professionals, she has made an indelible impact on women’s health and cancer care across Africa and beyond.

In this interview, Professor Anorlu shares her perspectives on the lesser-known facts about cervical cancer, the challenges of combating misinformation, the critical need for community engagement, and the exciting advancements shaping the future of cervical cancer prevention and treatment.

What is one lesser-known fact about cervical cancer that you wish everyone understood?

One lesser-known fact about cervical cancer is that it can be caused by certain strains of the human papillomavirus (HPV); however, not all HPV infections lead to cervical cancer. The immune system typically clears most HPV infections within a couple of years, and these infections usually do not cause any health problems.

Persistent infection with high-risk HPV types, particularly HPV 16 and 18, is responsible for the majority of cervical cancer cases. It’s important to note that not all women who acquire HPV 16 and 18 will develop cervical cancer. Several factors can influence the oncogenic potential of the virus, and women with these risk factors are at a greater risk of developing cervical cancer as a result of HPV infection compared to those without such factors.

I’ve encountered women who have undergone hysterectomies simply for being HPV positive. Some healthcare providers, due to a lack of knowledge about the pathogenesis of cervical cancer, may misinform women upon receiving a positive HPV test result.

How can organizations like STO support the ongoing education of healthcare professionals in the field of cervical cancer screening, prevention, and treatment?

We need to train more healthcare professionals, focusing not just on lectures but also on hands-on training. Support from organizations like STO can be instrumental in this effort. Prevention is especially crucial in low- and middle-income countries (LMICs), and we need to educate primary healthcare physicians about cervical cancer.

In Nigeria, patients often first consult private healthcare physicians, primary healthcare centers, maternity homes, church clinics, and even local chemists. It’s essential to educate these providers about the prevention and treatment of cervical cancer. Proper education is vital because a lack of knowledge can lead to the dissemination of incorrect information to the public.

Community engagement is also key. We need to inform the community that the elimination of cervical cancer is a long-term commitment, not a short-term project. The community must take ownership of the cervical cancer prevention initiative.

What recent advancements in cervical cancer research are you most excited about, and why?

Screening Advances. The use of HPV testing as a primary screening tool is proving to be more sensitive than traditional Pap smears. Self-sampling kits are also being promoted to improve access to screening. Additionally, point-of-care HPV testing and the treatment of pre-cancerous lesions can now occur in a single visit, which has significantly reduced loss to follow-up.

Screening has posed challenges in Nigeria and other low- and middle-income countries (LMICs). If we can overcome the barriers to screening, we will be on the path to cervical cancer elimination. The maximum impact of screening can be achieved in 20 years, compared to 40 years with vaccination.

Ongoing research is focused on addressing health disparities in cervical cancer outcomes, particularly among underserved and rural populations in LMICs. This includes understanding barriers to access and developing targeted interventions. If we can close this gap, we are making significant progress toward the elimination of cervical cancer.