According to The Cancer Association of South Africa (CANSA), the top three cancers affecting South African women are breast, cervical and colorectal cancer. ¹ It is estimated that these three cancers collectively caused over 170 000 female deaths in South Africa in 2020 alone. ² However, public awareness of the symptoms and early detection through screening, can help lead to an earlier diagnosis, resulting in improved treatment outcomes in these cancers. ³

How to lower your risk

PSST…. listen carefully - PREVENT, SCREEN, SYMPTOMS, TREAT EARLY!

The adage “Prevention is better than cure” is true for most illnesses and although some risk factors such as age, gender and family history cannot be changed, there are many risk factors for these three cancers that can be reduced or mitigated by dietary and lifestyle changes.

PREVENT

Although a positive family history of breast or colorectal cancer increases one’s lifetime risk, all women can develop these cancers, especially as they grow older. Lifestyle changes that can help decrease breast and colon cancer risk include maintaining a healthy weight, being active, eating a healthy diet (high fruit & veg intake, high fibre and low-fat diet, limited consumption of red & processed meats), limiting alcohol consumption, not smoking, and avoiding exposure to chemicals. ³

Cervical cancer is mainly caused by persistent infection with the Human Papilloma Virus (HPV), a common virus spread through skin-to-skin contact, body fluids and sexual intercourse. ³ Because of this prevention looks different to the other two cancers and includes using a condom during sexual intercourse (to prevent sexually transmitted infections, including HPV), avoiding multiple sexual partners, and waiting until 18 years of age before engaging in sexual activity. ^3,4 Vaccines that protect against HPV types 16 and 18 responsible for 70% of cervical cancers are also now available. ⁴ However, they should be administered before the onset of sexual activity and require 3 doses over a 6-month period. ⁴

SCREEN

Screening refers to tests and examinations used to find a disease in people who do not have any symptoms. ⁵ The goal of screen is to find the cancer early, before it causes symptoms (like a lump in the breast that can be felt). ⁵

Screening for breast cancer can include monthly breast self-examination (download our step-by-step Breast Self-Examination guide) and an annual clinical breast examination by a healthcare professional, although there is little evidence that these tests help find breast cancer early when women also get screening mammograms. ⁵ Research has shown that women who have regular mammograms (recommended annually from age 40 years ^3,5) are more likely to have breast cancer found earlier, are less likely to need aggressive treatments like mastectomy and chemotherapy and are more likely to be cured. ⁵

Screening for cervical cancer involves regular Pap smears – annually or at least every three years - in all women who have been sexually active starting from the ages of 18 to 20 years. ^3,4 It is however better to have a Pap smear at less optimal intervals, than not at all. ³ The South African National Department of Health’s Cancer Prevention and Control Policy allows for women to have three free pap smears in their lifetime, at ages 30, 40 and 50 years at public health clinics. ³

Most colorectal cancers begin as a polyp, a small growth of tissue that starts in the lining of the large intestine and grows into the lumen of the intestine. ³ A polyp can take as many as 10 to 15 years to develop into cancer. ⁶ Doctors can remove polyps during a colonoscopy, which is recommended every 10 years from the age of 50, and earlier (45 years) if there is a family history of colorectal cancer. ^3,6 Most people who have polyps removed during colonoscopy will need to repeat the procedure after 3 years, but some might need to get one earlier or later than 3 years, depending on the size, type and number of polyps. ⁶

SYMPTOMS

Although screening and early detection is ideal, awareness of the symptoms of these three cancers can also help lead to earlier diagnosis and improved treatment outcomes. ³ Symptoms to look out for include:

 

Breast cancer 3	Cervical cancer 3	Colorectal cancer 3,6
A puckering of the skin of the breast (orange-peel skin)	Abnormal bleeding between periods	Usually there are no symptoms   in the early stages
A lump in the breast or armpit	Heavier and longer menstrual period	Change in bowel habits  (diarrhoea, constipation, narrowing of stools)
Dimpling or retraction of the nipple	Vaginal discharge	Rectal bleeding with bright red blood
Nipple discharge	Vaginal bleeding or pain during intercourse/after menopause	Rectal bleeding with bright red blood
An unusual increase in the size of one breast	Passing urine more often than usual	Blood in the stools, which makes the stool look dark brown or black
		Persistent abdominal discomfort (cramps, gas or pain not related to diet)
		Weakness and fatigue
		Unintended weight loss

TREAT EARLY

It is important that women empower themselves with knowledge regarding lowering their cancer and health risk, undergo regular screening tests for early detection and learn to recognise the early signs and symptoms of these three cancers. ³ This is because:

• Breast cancer that is found early, when it is small and has not spread, is easier to treat successfully. ⁵
• Early diagnosis and treatment of pre-cancerous cervical lesions prevents up to 80 % of cervical cancers, in high resource countries, where cervical cancer screening is routine. ⁴
• Patients whose colorectal cancer is detected by screening colonoscopy have greater overall survival compared to patients with symptom-detected cancer. ⁷

​About Life Oncology 

Life Oncology is a dedicated oncology and radiotherapy service under the Life Healthcare network. Our prime objective is to revolutionise the cancer treatment journey by embracing a patient-centric and value-based model, supporting our patients and their families throughout their treatment journeys. To support this journey, we ensure that our care is coordinated, integrated, and personalised.

To download other cancer educational information, check the download section on the Life Oncology page here.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.

 

References:

1. The Cancer Association of South Africa (CANSA). South African Cancer Statistics. [online] 2019 [cited 2022 Oct17]. Available from: URL: https://cansa.org.za/south-african-cancer-statistics/.
2. Global Cancer Observatory (GLOBOCON). Cancer Tomorrow. [online] 2022 [cited 2022 Oct 17]. Available from: URL: https://gco.iarc.fr/tomorrow/en.
3. The Cancer Association of South Africa (CANSA). Women & Cancer. [online] 2016 Oct 6 [cited 2022 Jun 27]. Available from: URL: https://cansa.org.za/womens-health.
4. Mishra GA, Pimple SA, Shastri SS. An overview of prevention and early detection of cervical cancer. Indian J Med Paediatr Oncol 2011;32(3):125-132.
5. American Cancer Society. Breast Cancer Early Detection and Diagnosis. [online] 2022 Jan 14 [cited 2022 Oct 17]. Available from: URL: https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection.html.
6. American Cancer Society. Colorectal Cancer Early Detection, Diagnosis, and Staging. [online] 2020 Jun 29 [cited 2022 Oct 17]. Available from: URL: https://www.cancer.org/content/dam/CRC/PDF/Public/8606.00.pdf.
7. Brenner H, Jansen L, Ulrich A, Chang-Claude J, Hoffmeister M. Survival of patients with symptom- and screening-detected colorectal cancer. Oncotarget 2016;7(28):44695-44704.