Wearing their best babushkas and long flowing dresses, a group
of Uygur women crowd into a modest, rural clinic, their hazel eyes
twinkling thanks to an unexpected gift: free cervical cancer
screening.
A resident of the Kariliga village in Yutian County, Hotan
Prefecture in Northwest China's Xinjiang Uygur Autonomous Region,
Aijiaerhanmait Niyazi, 52, recalled the last time she had a
gynecological exam was more than 22 years ago.
"Since then, I haven't had the chance to see a (gynecological)
doctor until today," she said, holding a result of her colposcopic
evaluation.
Niyazi is visiting the Women's and Children's Health Station,
some 1,300 kilometers north of Urumqi, the seat of the regional
government.
The diagnosis is not very promising. "I have to wait for another
(a pathological) result to see if I need a further treatment," said
Niyazi.
She paused for a second and smiled. "I'm not afraid of anything.
I'm grateful. Without this free screening, I could have missed a
chance for early detection and treatment. Without that, I could be
dying of cervical cancer like some of the sisters in my village,"
she said.
Before the colposcopic exam, Niyazi had a HPV (Human Pallinoma
Virus) test, suggesting she was already infected with the
virus.
HPV causes genital warts and cervical cancer. The virus
infections are responsible for 99 percent of cervical cancer, the
second most menacing cancer next to breast cancer for women
worldwide, affecting 470,000 new cases annually, killing 230,000 of
them.
Dr Qiao Youlin, a notable epidemiologist with the Cancer
Institute at the Chinese Academy of Medical Sciences (CAMS) noticed
that "80 percent of the cases occur in developing countries, with
about 100,000 occurring in China every year. Most of them are found
among rural women like Niyazi in low resource areas, mostly in
China's impoverished west, such as Xinjiang."
Xinjiang has a population of 10 million women. "The incidence of
cervical cancer is 500 cases per 100,000, much higher than the
country's other areas," said Mayinuer Niyazi, 52, deputy president
of the regional People's Hospital, where she serves as an
obstetrician and gynecological oncologist.
An absence of medics and ineffective screening mechanisms in
rural areas are the key attributing factors to such a high
incidence.
"There are not many well-trained gynecological oncologists
available in the rural areas. And, going to see a gynecologist in
the city is something unimaginable for these female farmers unless
their condition becomes unbearable," she said.
Cervical cancer is easy to prevent as long as a regular
screening is provided, and is curable as long as it is detected
early and treated accordingly.
"But many continue suffer from the disease, and have lost their
lives to it only because these poor women cannot afford regular
screening," Mayinuer said.
In a bid to shield Uygur women from the threat of cervical
cancer, Chinese scientists from the CAMS's Cancer Institute, in
collaboration with the Cleveland Clinic Foundation in Ohio of
America, are conducting a community-based epidemiological study on
detection of a spectrum of HPV types and associated cervical
cancer, with the sponsorship of the American pharmaceutical company
Merck.
Thanks to the project, 1,000 Ugyur female farmers coming from
seven townships of Yutian County are receiving free gynecological
checkups, including HPV tests, liquid-based cytology, visual
inspections with acetic acid and colposcopic exams, to identify
pre-cancerous lesions in cervix.
Doctors and scientists from the Cancer Institute have discovered
that sanitary conditions in Yutian are shockingly depressing. "Many
women don't know what sanitary pads are. They use sand instead of
sanitary pads during their periods," said Wu Yanping, a
statistician from the institute's Cancer Epidemiology
Department.
Out of those 1,000 screened women, she said, nearly 9 percent
are high risk type HPV infected. And most suffer some erosion in
the cervix at a different level.
To raise awareness of this health problem, experts from Beijing
are teaching rural women the knowledge of personal hygiene. They
are also teaching them how to perform a self-examination, which is
a primary and vital method to identify possible pathological
changes in the cells of the cervix.
(China Daily December 21, 2006)