FOREWORD Cervical cancer is one of the commonest cancers diagnosed in women in South Africa. The main cause of cervical cancer is infection of the cervix by the Human Papillomavirus (HPV), of which strains 16 and 18 are the most common types associated with the development of cervical cancer. Cervical cancer is a relatively unique cancer in that it has a long precursor phase, during which risk and abnormalities can be detected by screening. Screening can now be done by both the Papanicolaou cytology test (Pap smear) and by detecting persistent infection with high risk types of HPV. Positive screening tests, left untreated put a woman at high risk of progressing to cervical cancer over a 5 30 year period. – Once these abnormalities are detected and treated, progression to invasive cancer of the cervix can be prevented. The National Department of Health has a trial based programme in place to address several women’s health issues, including cancer of the cervix. Organized cervical cancer screening for eligible women is the central element within the existing cervical cancer prevention strategy of the Department. This policy updates the existing strategy to take into account technological advancements in cervical cancer prevention and new evidence on prevention, approaches and methods in context of the HIV epidemic. This updated policy also provision for the introduction of primary prevention of cervical cancer through HPV vaccination of young girls aged 9-13years, and the promotion of awareness regarding HPV prevention through safe sex practices and dual protection (barrier plus other methods of contraception). It provides for secondary prevention through strengthening cytology screening and introducing test-and-treat in resource-limited settings, where treatment follows immediately after a positive screening test; and HPV DNA-based screening where resources permit, in the public sector (WHO guidelines, 2013). The policy makes provision for all HIV negative, asymptomatic women over the age of 30 years attending public sector health services to undergo three free cervical cancer screening tests at ten year screening intervals. It also introduces new guidelines for cervical cancer screening for HIV positive women. Screening these target groups has been proven through numerous international and
FOREWORD Cervical cancer is one of the commonest cancers diagnosed in women in South Africa. The main cause of cervical cancer is infection of the cervix by the Human Papillomavirus (HPV), of which strains 16 and 18 are the most common types associated with the development of cervical cancer. Cervical cancer is a relatively unique cancer in that it has a long precursor phase, during which risk and abnormalities can be detected by screening. Screening can now be done by both the Papanicolaou cytology test (Pap smear) and by detecting persistent infection with high risk types of HPV. Positive screening tests, left untreated put a woman at high risk of progressing to cervical cancer over a 5 – 30 year period. Once these abnormalities are detected and treated, progression to invasive cancer of the cervix can be prevented. The National Department of Health has a based programme in place to address several women’s health issues, including cancer of the cervix. Organized cervical cancer screening for eligible women is the central element within the existing cervical cancer prevention strategy of the Department. This policy updates the existing strategy to take into account technological advancements in cervical cancer prevention and new evidence on prevention, approaches and methods in context of the HIV epidemic. This updated policy also provision for the introduction of primary prevention of cervical cancer through HPV vaccination of young girls aged 9-13years, and the promotion of awareness regarding HPV prevention through safe sex practices and dual protection (barrier plus other methods of contraception). It provides for secondary prevention through strengthening cytology screening and introducing test-and-treat in resource-limited settings, where treatment follows immediately after a positive screening test; and HPV DNA-based screening where resources permit, in the public sector (WHO guidelines, 2013). The policy makes provision for all HIV negative, asymptomatic women over the age of 30 years attending public sector health services to undergo three free cervical cancer screening tests at ten year screening intervals. It also introduces new guidelines for cervical cancer screening for HIV positive women. Screening these target groups has been proven through numerous international and trial
ZAF_D1_CaCx%20Policy%202017.docx