The Correlation between Cervical Cancer and FGM

Cervical cancer is a type of cancerthat occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina. According to medical documentation, various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancersCervical cancer can usually be cured, if it is caught and treated in the early stages. 

The cervix is the lower, narrow end of the uterus (the organ where a fetus grows). The cervix leads from the uterus to the vagina, which is the birth canal.  Long-lasting infections with certain types of HPV account for almost all cases of cervical cancer.  Having a pap test to check for abnormal cells in the cervix or a test to check for HPV can find cells that could become cervical cancer. These cells can be treated before cancer forms.

Although studies continue to be conducted, medical research studies show that there very well could be a correlation between cervical cancer and female genital mutilation (FGM).  Some medical personnel report that it is difficult to perform pap tests on women who have undergone the infibulation type (Type 3) of FGM.  Cervical cancer is one of the leading causes of death for middle-aged women in developing countries, yet the disease is almost completely preventable if precancerous lesions are identified and treated in a timely manner.  And not being able to have pap tests done on them could put the survivors of FGM at high risk of developing cancer of the cervix.

About four years ago, one hundred and fifty women between the ages of 25 and 50 were invited to participate in a cervical cancer screening project in Africa, and 100 women attended the screening clinic, which was considered to be a response rate of about sixty-seven percent.   About half of the women that participated in the screening were around the age of 35.  Thirty-six percent of the women had no education and only thirty-three percent of them were employed. It was reported that as high as sixty-four percent of the participating women had undergone female genital mutilation. Sixty percent had given birth more than once, while sixty-two percent had had incisions between the anus and vulva during childbirth; twelve percent of the women appeared to have had lacerations in that area.

The result of the study showed that episiotomy, cervical laceration, and genital mutilation are considered major types of iatrogenic trauma.  The study found that trauma to the cervix is a risk factor for cervical cancer, and points to the importance of safe delivery facilities.  It was strongly noted that the abandonment of FGM can have a great effect in decreasing the chances of cervical cancer in women in developing countries.

According to the U.S. Library of Medicine, FGM has led to many complications, in particular, the scarring of the external genitalia, which makes treatment difficult when surviving women develop cancer of the cervix.  The Library said every effort should be made to ensure that genital mutilation on women does not deprive the women of the same standard medical care which the general population receives.  The Library of Medicine further states that even though clinical and epidemiological studies have established a close association between inflammation and the initiation of cancer formation, especially in epithelial cancers, the relationship between FGM and cervical cancer is still not well known.  The Library conducted an analysis using combined data from six research studies that had been conducted in and around Dakar, Senegal from 1994 to 2012. The subjects for the study included both women showing no symptoms who had been screened for cervical cancer, and women with already cancer symptoms who were referred for cervical cancer treatment.  They used unconditional logistic regression to estimate adjusted ratios and confidence intervals for associations between FGM and Invasive cervical cancer, as well as noninvasive cervical abnormalities. After adjusting for confounding, women with invasive cervical cancer were almost three times more likely to have undergone FGM, than women without cervical abnormalities.  The Library’s study showed that no significant associations between FGM and noninvasive cervical abnormalities were observed, except in commercial sex workers with FGM.  They concluded that potential increased risk for invasive cervical cancer suggested by their study warrants further examination. They believe that the study results could very well impact cancer prevention efforts in those populations where FGM is practiced, and could also draw awareness to the additional health risks associated with FGM.

It should be common knowledge in medical circles that FGM causes lifelong emotional difficulties, which makes getting pap tests extremely hard for women who have experienced FGM. From an emotional perspective, the surviving women have to go to the General Practitioner, and then would have to disclose that she underwent FGM as a child.  The anticipation of that alone causes a great deal of anxiety and it becomes difficult for the women to talk about it.  That is most especially if the women have experienced a previous bad reaction from a healthcare professional. The position the test requires the women to assume, and the fact it involves the lower part of their bodies, can cause them to have flashbacks.  Some women have said they felt violated all over again.  From the physical aspect, pap tests can be difficult, or even impossible, for women who have undergone FGM, especially those who have experienced type 3 (infibulation). It causes problems for a nurse to see the cervix clearly and take a sample of cells. It also makes pap tests extremely painful.

As an end note to all women, but most especially women who are survivors of FGM; please do not postpone having pap tests.  It is crucial to your health to visit the OB/GYN, and schedule a pap test, in spite of the possible difficulties.

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