The big five cancers affecting women in South Africa

October is Breast Cancer Awareness Month, an annual campaign to increase awareness of the disease.

According to the Cancer Association of South Africa (CANSA), breast cancer is not the only cancer affecting women in South Africa.

Statistics from the National Cancer Registry (NCR) 2016 show that the top five cancers affecting women are breast, cervical, colorectal, uterine and lung cancer.

CANSA places focus on women reducing their cancer risk during August and October. However, the organisation encourages women to make their health a priority all year round, by knowing what is normal for their bodies, and to be aware of the symptoms of cancer.

Women should undergo annual medical check-ups and cancer screening for early detection, as symptoms don’t always present until the disease has spread. Women need to lead a balanced lifestyle, cutting out lifestyle factors that increase their cancer risk.

1. Breast cancer

Apart from non-melanoma skin cancer, breast cancer is the most common cancer in women of all races, with a lifetime risk of 1 in 25 in South Africa, according to the (NCR 2016).

The risk for breast cancer increases as women grow older, but many women under the age of 40 are diagnosed with breast cancer. All women are at risk, and in particular women with a family history of breast cancer. Being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals also increases risk.

Reduce risk with regular self-examination.

Breast Self-Examination:

While not all breast lumps indicate cancer, they should be investigated, especially if accompanied by other changes in breasts or the under arm area, such as lumps, texture changes, thickening, dimpling, changes in shape or size of nipples or breasts, tenderness, discharge, rash or swelling, or one breast suddenly being slightly larger than the other.

Research has shown that a regular Breast Self-Examination (BSE), plays an important role in discovering breast cancer, compared to finding a breast lump by chance.

A BSE should be done once a month, preferably at the same time of day, following a woman’s menstrual cycle.

Clinical Breast Examination:

A Clinical Breast Examination (CBE) is a visual and manual examination of the entire breast, from the collarbone to the bra line, and from the armpit to the breast bone. It is advisable to have a CBE as part of your annual medical check up.

Women are entitled to an annual clinical breast examination when visiting primary health care centres (according to the National Department of Health’s Breast Cancer Control Policy).

Contact your local CANSA Care Centre, primary health care centre or health practitioner to arrange for a CBE.

Should any abnormalities be detected, the patient will be referred for further testing by a medical professional.

Mammograms:

Mammograms (a special x-ray to detect lumps in the breast) do not prevent breast cancer, but they can save lives by finding breast cancer as early as possible.

Finding breast cancers early with mammography also means that many more women being treated for breast cancer are able to keep their breasts. When caught early, localised cancers can be removed without resorting to breast removal (mastectomy).

Women over the age of 40 should go for an annual mammogram, for purposes of non-symptomatic breast screening.

Women 55 years and older should have a mammogram every two years – or if they choose, continue with an annual mammogram.

Women who have other risk factors such as mutated BRCA1 /2 gene, should be referred for an annual mammogram.

2. Cervical cancer

It is the second most common cancer among South African women.

Women have a 1 in 35 lifetime risk of cervical cancer (NCR 2016). It can be successfully treated if detected early, so it is important that women are aware of symptoms and what is normal for their bodies.

Symptoms include abnormal bleeding between periods, heavier and longer menstrual periods, vaginal discharge, vaginal bleeding or pain during intercourse/after menopause and increased urinary frequency.

Cervical cancer is mainly caused by the Human Papilloma Virus (HPV), a common virus spread through skin to skin contact, body fluids and sexual intercourse. Failure to use protection during sexual intercourse, sexually transmitted infections (STIs), multiple sexual partners, early sexual debut, and use of oral contraceptives increases risk.

Women with HIV infection also have a higher risk of developing cervical cancer.

Pap smears:

Having regular pap smears can detect abnormal cells in the cervix (lower part or mouth of the womb), that could develop into cervical cancer. Screening involves taking a swab of the cervical cells. It is uncomfortable, but painless.

Women who have been sexually active should start having pap smears between the ages of 18 and 20 years.

Every woman should preferably have a pap smear at least every three years.

Vaccinations:

CANSA supports the Department of Health’s Human Papilloma Virus (HPV) school vaccination programme to help reduce cervical cancer risk.

Persistent infection with HPV may lead to cervical cancer, so all females in the age group nine to 26 years (provided they are not sexually active) may be vaccinated.

Women who have had the vaccination should continue to be screened for cervical cancer.

3. Colorectal cancer

Colorectal cancer or colon cancer is the third most common cancer affecting women in South Africa. One in 127 females are at risk of being diagnosed with colorectal cancer (NCR 2016).

Most colorectal cancers begin as a polyp, a small growth of tissue that starts in the lining and grows into the centre of the colon or rectum. Doctors can remove polyps during the colonoscopy procedure.

CANSA continues to appeal to women to get to know their bodies and start looking out for any telling signs and symptoms that may indicate colorectal cancer. Should women experience abnormal symptoms, they should request a referral for a colonoscopy to screen for cancer.

Symptoms include a change in bowel habits (diarrhoea /constipation), rectal bleeding or blood in stools, and persistent abdominal discomfort (cramps, gas or pain).

CANSA recommends a colonoscopy from the age of 50, every 10 years.

4. Uterine cancer

Cancer of the uterus, also as known as uterine cancer or womb cancer is the fourth most common cancer affecting women in South Africa.

One in 135 women is at risk of being diagnosed with uterine cancer (NCR 2016). The most common form of this cancer affects the lining of the uterus, known as the endometrium and is also referred to as endometrial cancer. A hormone imbalance causes the lining of the uterus to thicken. If the lining builds up and stays that way, cancer cells may start to grow.

Symptoms include abnormal vaginal discharge or bleeding (high volumes between periods), long and heavier than normal menstrual bleeding, and pain or pressure in the pelvic area (especially when urinating or during sexual intercourse).

Women who are 50 and older, have diabetes, or who have a family history of uterine cancer or endometrial polyps, infrequent menstrual cycle, menses starting before age of 12, have used oestrogen replacement therapy without the use of progesterone are more at risk.

Other risk factors include being overweight, inactive, consuming alcohol, poor dietary habits, and smoking.

5. Lung cancer

Lung cancer occupies the position of fifth most common cancer and South African women have a lifetime risk of 1 in 182 (NCR 2016).

This cancer doesn’t typically cause symptoms in its earliest stages, but symptoms present when the disease is already advanced.

Symptoms include a chronic cough; a cough that gets worse and does not go away; coughing up blood (even a small amount); shortness of breath or wheezing; constant chest pain (especially when coughing); frequent chest infections; a chest infection that lingers; hoarseness and feeling tired all the time.

Statistics reveal that the more a person smokes, the greater the risk of developing lung cancer.

It’s also more likely to develop in people who start smoking at a young age. Being exposed to passive smoking and chemicals can also increase risk.

For more information contact CANSA at 0800 22 6622 or 072 197 9305 (English and Afrikaans) or 071 867 3530 (Xhosa, Zulu, Sotho and Siswati) or email info@cansa.org.za

Visit the website at www.cansa.org.za

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