Cervical cancer is the fourth most frequently diagnosed cancer and fourth leading cause of cancer death in women worldwide. In Ethiopia, it is the second most frequent form of cancer and leading cause of cancer deaths among women. 99.7% of Cervical Cancer is caused by Human Papilloma Virus that transmits through sexual intercourse. In our country, cervical cancer causes an estimated 7,445 new cases and about 5,338 deaths every year; over 80% of cases are detected at a late stage, predominantly due to lack of information about the problem. In line with the WHO global strategy (90-70-90 i.e., reaching the target of 90% HPV vaccination, 70% cervical screening and 90% cervical cancer treatment by 2030), the Ministry is following the strategy of strengthening the existing services including scale-up of secondary cervical cancer screening & treatment to ensure service is accessible in the country. The ministry is also conducting extensive community awareness and demand creation through various media outlets on cervical cancer.
Ethiopia introduced HPV vaccination in December 2018 for a single age cohort of 14-year-old girls, with a one-week campaign design school-based strategy providing as the key platform. As of June 2023, more than 6.5 million target girls have been vaccinated for the first dose of HPV vaccination and 4.2 million for their second dose. Following the recent recommendation of E-NITAG on the single dose HPV vaccination the country is preparing for a MAC (Multi Age Cohort) Vaccination of 9- to 13-year-old girls in November 2023. Furthermore, the country is going to start to introduce the HPV vaccine through the routine immunization program.
The Ministry so far has expanded the cervical cancer screening service from 5 health facilities providing the service in 2009, to 1,330 health facilities in 2023. Among these 50 hospitals are providing LEEP services for lesions that are not eligible for cryotherapy and Thermal Ablations. The cervical cancer screening service has been recorded since 2015, and a total of 1,259,253 (12%) women have been screened for cervical cancer till 2023.
In general, the country has taken significant strides to address cancer care gap. A national cancer control strategy has been developed, focusing on a continuum of care approach: Primary Prevention; Early Detection; Diagnosis and Treatment; and Palliative Care. Implementation of the strategy in underway.
In addition to the surgical service, radio therapy cancer treatment provided to the patients based on their treatment needs. Currently, in addition to Black Lion Specialized hospital, Jimma university referral Hospital and Harromaya university hospital, have already started radio therapy services with 3D-LINAC Machine. Moreover, Hawassa University and Gondar university hospitals are centers that are going to start the service so as to make an equitable geographic distribution throughout the country.
Trend of Screening and Treatment service expansion from 2009-2023