Conclusion
Cervical cancer is endemic in sub-Saharan Africa and other parts of the
developing world, that are least prepared to deal with a high burden of
disease. The current methods of screening and treatment for cervical
dysplasia and invasive cancer have clearly not achieved the same results
in the developing world as they have done in the developed world towards
reducing the burden of this disease. With up to nine out of 10 cervical
cancer cases and deaths occurring in LMICs 2 and the
disease being the most commonly diagnosed cancer in 28 of these
countries and the leading cause of cancer death in 42 countries5, it has become imperative that innovative ways of
dealing with the problem of cervical cancer in sub-Saharan Africa and
the developing world are found. Ideally this innovative approach would
address the limitations posed by the current methods of treatment for
cervical dysplasia, as well as being able to be integrated into the
existing VIA screen and treat strategy used in this region, which
negates the need for trained clinicians and expensive medical
infrastructure. An ideal locoregional therapy for HPV-induced cervical
lesions to be used in this setting would be a cytotoxic anticancer agent
which would target the pre-neoplastic lesion with high selectivity for
diseased epithelium and non-toxic to normal tissue and low systemic
absorption. The anticancer agent must be readily available, safe to use
in women of child-bearing age and effective. The formulation would be
self-administered with increased residence time at the cervix and
therefore require a minimum number of applications, for it to be
acceptable to patients. In this growing area of research, developing a
drug-based locoregional treatment for cervical dysplasia which can be
administered at the time of screening by a nurse or even by the patient
themselves and with no requirement for specialized equipment, could
prove to be the game-changer that sub-Saharan Africa so desperately
needs in the fight against cervical cancer.