 Welcome back. It's still the breakfast and plus TV Africa. And of course, we're set for our second major conversation, January, as we said before the break is cervical cancer awareness month. It is said to be a perfect opportunity for the World Health Organization and its partners to raise awareness about cervical cancer and HPV vaccination. Don't worry, we'll get to know all that means. Well, we're told that 19 of the top 20 countries with the highest cervical cancer burden were in sub-Saharan Africa in the year 2018. Cervical cancer presents a significant public health threat to women on the African continent, all but one of the top 20 countries worldwide with the highest burden of cervical cancer in 2018, like we said, we're in Africa. What do we need to know about this ailment so that we live a long and healthy life? So we have joining us to discuss this Dr. Blossom, Madua Fokwa. She's a public health physician joining us as well as in Ligas. Dr. Madua Fokwa, good morning to you and thank you very much for your time. Good morning, Kofi. Thank you so much for having me. All right, all right. What is cervical cancer? Let's start from the basics. Yes, so cervical cancer is a disease that affects the neck of a woman's womb. So the neck of a woman's womb is like right below the womb, the womb is where the baby stays. So a cancer is a disease that not only affects the cell of the organ where it's part, but it can actually spread to other parts of the body and eventually it will lead to death. Wow, wow, wow. What are the risk factors for cervical cancer? So cervical cancer is a very interesting cancer. It's one of the cancers that we actually know the cause of this cancer in 99% of the cases. Cervical cancer is caused by a virus called human papillomavirus. So it's interesting in other cancers like breast cancer, colon cancer, we know, okay, let's say if you don't exercise or if your diet is high in fat, you're at risk. But in this particular cancer, we actually do know the cause and the cause in most of the cases is human papillomavirus. And it is sexually transmitted infection. And most people that are sexually active have actually come in contact with human papillomavirus. So it's actually quite common. This is a worry, worry. Are you saying the cervical cancer is a sexually transmitted disease? Absolutely, yes. Wow. Wow. And this is what a lot of people don't realize, yes. Wow, that's surprising, really. So I mean, the risk factors here you're talking about is it unprotected sex maybe or having sex with an infected person? Yes, absolutely. Yes, so having sex with someone that is infected. But the difference between human papillomavirus and other sexually transmitted diseases like gonorrhea, syphilis, even HIV is ubiquitous. That is to say, everywhere. So if you've had unprotected sex, even once in your life, most likely you have come in contact with the human papillomavirus. Wow, wow, wow. Yes. So I mean, this human papillomavirus you're talking about, I hope I have mentioned it right. Yes, you are. How does one, maybe for instance, a carrier contract it? Is it hereditary? Because for someone to share it, they must have gotten it all. Is it basically just spread from person to person? Is it hereditary factor, a gene factor here? Or DNA factor here? So it's not hereditary, it's spread from person to person. So it sounds bleak as you're hearing it, but I don't want to say the good thing about human papillomavirus, but the thing about human papillomavirus is in 95% of cases, the infection will resolve on its own. So it will resolve and the individual wouldn't even know that they had the infection. So in 95% of cases, it resolves without doing any harm to the individual. But in 5% of the cases, it can now progress to cancer, it can not just progress to cancer of a cervix, it can progress to cancer of the oral cavity, the throat, the aenus, any part of your body that engages in sexual activity, it can actually progress to cancer in those areas. But usually in about 5% of the cases. Why, I know the kids are watching this morning, so I'm going to have to change the way I'm asking this question, these questions, but why the throat? Okay, so people that engage in oral sex, for example, so it can be transmitted from the perineal cavity from the pubic area, from the vagina to the throat. So people that engage in anal sex, it can also be transmitted to that area as well. All right, I think we will substitute the S word for intercourse, maybe just. Okay, yeah, okay. Yes, yes, yes. Those weren't really things. This is a heated topic, it's more heated than I thought it would be. But for the person who has it, I don't know, maybe the first person who ever had it, for people who do not engage in unprotected intercourse with persons who are carrying this human papillomavirus, is there another way to transmit it? Or is it not known to the pub to maybe sign so far, I mean, if there are other ways of getting it? Because, I mean, apart from unprotected intercourse, let's say. You also, like I said, it's a sexually transmitted infection, so that's really how it's transmitted. But that's actually not the big news. The big news here is 95% of the cases it will resolve, if 5% of the cases it will progress. But the bigger and the more interesting news is, it takes so long to progress from human papillomavirus infection to cervical cancer, for example. It can take up to 20 years. So that 20 years presents you with the opportunity to pick it up with screening tests and actually have it treated and you'll be completely fine. So we have so many screening tests that we do. We actually do have a vaccine for the human papillomavirus. So there's so many layers of protection that have been made available. And like you said at the beginning, most of the deaths from cervical cancer are for in lower middle income countries like Nigeria. And that's because of lack of healthcare access. So people lack access to the vaccine, people lack access to screening tests like the Pap smear, people lack access to all these protective services that can actually prevent you from either developing cervical cancer or dying from cervical cancer. So people actually don't realise in parts of the West, like the US, the UK, Europe, people really don't die of cervical cancer anymore because at four points your healthcare provider is going to pick it up and going to treat it and then you'll be fine. Interesting. Okay, so this is very good information and you're putting out here. Since we've seen it affects the women, how about men? Because the statistics that we put out earlier talking about, is it or something that the men are in danger of? Because the intercourse, most times we have legally and officially, it's between male and female. Yes, that's a fantastic question. I'm glad you asked that question. So back to what I had said initially. So you know, we've started vaccinating children between the ages of nine and 14 with the human papillomavirus vaccine. We are vaccinating boys and girls and this is why we're doing that. Because usually the man can transmit the virus to the woman, but if he's already vaccinated then he's not going to get the infection. That's fine. But for the men, if they engage in oral intercourse for example, they can actually get the human papillomavirus in the oral cavity on the throat and it can actually cause cancer in those areas. For people that engage in oral intercourse as well, they can actually have anal cancer from human papillomavirus. So that's how men are affected. Men don't have cervixes obviously, but they can have oral cancer through cancer and anal cancer as well from human papillomavirus. Hmm. Okay. Yes. All right. So we'll come to the prevention very quickly. We're almost out of time. So from what you've said, taking the vaccine as you mean, it's the HPV vaccine. It's one of the ways of preventing this. Is a vaccine for children alone? Can adults take it as well? Great question again. So the recommendation is children taking it between the ages of 9 and 14, they take two doses. From the ages of 15 and 26, they take three doses. After the age of 26, you have to have a discussion with your healthcare provider to understand your exposure, your possible exposure, and then your healthcare provider can advise as to whether you will benefit from the vaccine, depending on the level of exposure you've had who advised whether you benefit from the HPV vaccine or whether you should just go ahead and do other screening tests like HPV virus tests. There's a test for the HPV virus which you can readily get. Or you can get what we call the pap smear or you can get what we call the DIA. So these are things that you can do if you can't, if your healthcare provider decides that you may not benefit from the vaccine because you've already been widely exposed to the virus. You said it takes about 20 years for it to progress to the first stage. For those who get tested and they found to have this virus before it gets to the cancer stage, can they take a pill for it? Is there a cure? Yes, absolutely. So what happens is you get the HPV test. So what we usually do, we give you the test along with the pap smear for the females. If you test negative for the HPV virus and you test negative on the pap smear, you don't get tested again for five years. But if you do get, if you get to get tested and you're positive, you have to see you in one year. So depending on the level of advancements that we see, for example in your pap smear, you might want to see you in six months and for some people, you might actually need to get treated immediately. So treatments are ready, they are available. We have cryotherapy, we have resection, there are so many things that can be done but you can actually get treated and not progress to advance cancer. How can people on Weapon Quick and People get tested and what's the recommendation for males and females to get tested? Is it every year? What kind of tests do they need to do? So the test is called the Human Papillomavirus Test. So it's available at lab facilities around Lagos. Some tertiary facilities also operate. So if you speak to your health care provider, they will be able to refer you to a lab facility that offers that test. So you just get yourself tested and for the females you get your pap smear done and once the results are reviewed and it's negative, you're basically fine for the next five years and then after five years you get tested. So now the HPV test is a little bit expensive so not everyone can afford it. For people that cannot afford it, you can get the pap smear. If your pap smear is negative, then we don't see you for the next three years. So you do it every three years if it's negative up to the time that you're 60 years old, after 60 years old you're going to do it every year for three years and then after that you don't do it at all. Okay. Will you advise sexually active, there we go again, adults, to stay off oral intercourse and anal intercourse just so they can stay safe and stay alive. I'm not judging anyone here but just for their safety. No, that's not what I'm here for. I'm not here to tell people what to do in their private spaces. I'm just here to present what options are available to protect yourselves and to prevent the stressful, high-primary mental disease. So I'm not going to tell you what to do at your own private time. Because if we hear that the advice is that the husband should refrain from the oral, maybe it might cause some issues in some marriages. I like the way you put it. All right. Is there anywhere people can get more information from? Is there anywhere people can get more information from? So yeah, people can get more information with the association of public health physicians of Nigeria and Lagos, France. So you can follow us on Instagram, APHPN Lagos. We have periodic information sessions that we put out there. So you can get a lot of information. You can also get really good information from the World Health Organization website. So these are really good sources where you can get accurate information. Yes. All right. Fantastic. Fantastic. Anything you want to add before we go? All I want to add is for your viewers, anyone listening to us right now, this might be the wake-up call that you need. Go to your health care provider. Remember, the PAPS smear is very cheap. It's not expensive. You can get it done and it can actually save your life. And if you have children between the ages of 40, please do get them vaccinated against HPV vaccine. Against HPV virus with the HPV vaccine. Please take care of yourself. Take care of your loved ones. Spread the information you could actually save someone's life. All right. Dr. Blossom Madua Fokwa is a public health physician and also the Public Relations Officer for the Association of Public Health Physicians of Nigeria Lagos. Blossom, thank you very much for your time. Thank you so much for having me. It was great. It was great being here. Fantastic having you and look forward to having you again. Thank you very much. And that's the size of our package. Very important, as she says, go get tested. The human papillomavirus test and for our ladies, where it's very important and you can decide if you want to stay away from the other things she talks about. Okay. Don't look at me like that. My name is Kofi Bartels. Please follow us on social media at Plus TV Africa, Facebook, Twitter, Instagram. And of course on YouTube, we have two accounts, Plus TV Africa and Plus TV Africa Lifestyle. We're back tomorrow with more right here on the breakfast. Have a wonderful day. Up next is the news brief at night.