We rarely talk about it, but we should — the virus behind one of the most preventable cancers in the world. This October, BellaNaija began the #StopHPVForHer campaign to break the silence around HPV and cervical cancer. It’s a call to action for women to learn, ask, and protect themselves through screening and vaccination before the disease ever takes hold.
Still, many women are unsure where to begin and they have questions. What exactly is HPV? How does it lead to cervical cancer? And what can women do, today, to protect themselves, their daughters and the people they love?
To help demystify the subject, Dr. Aisha Mustapha, a leading gynaecologic oncologist at Ahmadu Bello University Teaching Hospital, sat down with BellaNaija to unpack the facts. As the President of the Medical Women’s Association of Nigeria (Kaduna State Branch) and Co-Chair of the Nigerian Cancer Society’s Training Committee, Dr. Mustapha breaks down what HPV really means, it’s link to cervical cancer and explains what every woman should know about vaccination, screening, and the simple steps that can prevent one of the world’s most avoidable cancers.
Cervical cancer is often described as one of the most preventable cancers — can you break down what makes it preventable?
Cervical cancer is almost 100% preventable because of two reasons. First, we know the exact cause, which is persistent infection with high-risk Human Papillomavirus (hrHPV). Second, there is a long latency period between hrHPV infection and cervical cancer. These reasons give us two powerful lines of defense, known as primary and secondary prevention.
- Primary Prevention: The HPV vaccine is the most effective tool for cervical cancer prevention. It is most effective when given to adolescents (boys and girls) before they become sexually active. By stopping the initial infection with hrHPV, we prevent the entire disease process from starting. Nigeria is currently vaccinating girls aged 9 years free-of-charge across all Primary Health Centres across the country.
- Secondary Prevention: Screening and Early Treatment. Cervical cancer takes a very long time—sometimes 10 to 20 years—to develop from an initial HPV infection into real cancer. Screening tests (such as Visual Inspection Tests, Pap smear and HPV test) give us a massive window to detect the abnormal cell changes, known as pre-cancers, long before they turn into full-blown cancer. When we find these pre-cancers, we remove them with a simple procedure, stopping the cancer entirely. Nigeria recently launched the national screening guidelines.
Because we can prevent the cause (with the vaccine) and detect and treat the warning signs (with screening), cervical cancer is the most preventable cancer
What are the key warning signs or symptoms women should never ignore when it comes to cervical health?
The most crucial thing to remember is that precancerous changes rarely cause symptoms, which is why screening is vital even if you feel perfectly well. So, the warning sign you should never ignore is your calendar reminder for cervical screening!
However, once cervical cancer begins to grow, the symptoms are almost always related to abnormal bleeding and discharge. Women should never ignore:
- Abnormal vaginal bleeding: This includes bleeding after sexual intercourse, bleeding between menstrual periods, or any vaginal bleeding after menopause.
- Unusually heavy or long menstrual periods: If your periods suddenly change to become significantly heavier or last longer than is normal for you, see a doctor.
- Unusual vaginal discharge: A persistent discharge that may be watery, pale, foul- smelling, or contain traces of blood.
- Pelvic pain or pain during intercourse: While these symptoms can be caused by many other conditions (like infections or fibroids), if they are new or persistent, they warrant an immediate medical consultation.
If you experience any of these symptoms, please consult a healthcare professional immediately. Don’t wait, and don’t assume it’s simply an infection.
How effective is the Pap smear or HPV test in detecting early changes that could lead to cervical cancer?
Both the Pap smear and the HPV test are highly effective and are the cornerstones of secondary prevention. They work differently but complement each other:
- The Pap smear (or Pap test): This test looks for abnormal cells on the cervix. By identifying these cells, we can spot precancerous changes that are developing.
- The HPV test: This test looks for the presence of the high-risk HPV virus itself. Since the virus causes the cancer, knowing a high-risk strain is present tells us who is most at risk and needs closer monitoring.
Some screening programmes use co-testing (doing both tests at once) or primary HPV screening (testing for the virus first). The detection process is incredibly effective: when we find precancerous changes and treat them, we prevent the development of cancer in well over 95% of cases. A negative HPV test is also reassuring, as it means your risk of developing cervical cancer in the next five years is extremely low.
There’s still stigma and fear around gynaecological exams. How can we normalise regular cervical screening among women in Nigeria?
This is a critical challenge, especially across low-resource settings like northern Nigeria. To normalise screening and overcome the barriers of fear, stigma, and accessibility, we need a multi-faceted approach:
- Massive education campaigns: We must demystify the disease and the screening process. Information should be shared through community leaders, religious groups, and in local languages, focusing on the simple message: “Screening saves your life.” We need to address misconceptions and normalise conversations around reproductive health.
- Using accessible technology: For women who fear the exam or have poor access to clinics, the promotion of HPV self-sampling is a game-changer. This allows a woman to collect her own sample in a private setting, which is then tested for the HPV virus. It’s as reliable as a sample taken by a provider.
- Adopting the “See and Treat” model: In Nigeria, the Visual Inspection with Acetic Acid/Lugol’s Iodine (VIA/VILI) and subsequent Thermocoagulation (“See and Treat”) approach is highly effective and feasible for primary healthcare settings. It allows women to get screened and, if a precancerous lesion is found, treated in a single, short visit, reducing the need for multiple, embarrassing, and intimidating hospital visits.
- Training and sensitisation of health workers: Ensuring our providers are trained to be empathetic, professional, and excellent communicators during gynaecological exams can reduce anxiety and build trust in the process.
Beyond screening, what treatment options are available for women diagnosed with cervical cancer, and how does early detection affect outcomes?
The treatment for cervical cancer is highly dependent on the stage of the disease, which is why early detection is absolutely vital.
- For very early stage (Micro-invasion): Cone biopsy (Conisation) or Loop Electrical Excision Procedure (LEEP). These are minor procedures.
- For early-stage invasive cancer: Surgery (Radical hysterectomy or Trachelectomy). Radiation Therapy and Chemotherapy (chemoradiotherapy) can be used as the primary treatment, especially if they are larger or have grown into surrounding structures.
- For advanced or locally advanced cancer: Chemoradiotherapy and brachytherapy.
- For recurrent disease or very advanced disease: newer options like targeted therapy and immunotherapy are increasingly available but not yet in Nigeria.
Early detection is, quite literally, lifesaving. This is the most compelling argument for regular screening because catching it early means a cure with minimal intervention, often allowing for fertility preservation.
