Arvind Mathur, WHO Representative to Timor-Leste
DILI, 22 january 2024 (TATOLI) – The burden of cervical cancer remains a pressing issue in Timor-Leste, impacting lives of numerous women and their families. In 2019, about 28 women lost their lives due to the disease, with the actual number of fatalities and affected individuals remaining underreported.
Annually, an estimated 10 cases of cervical cancer occur for 100,000 women in Timor-Leste, and six women die per 100,000 women due to this cancer. Globally, cervical cancer is among the major causes of cancer mortality in women, with over a quarter of its global burden contributed by developing countries.
The trends seen in Timor-Leste are similar to those observed worldwide, with over 85 percent of affected individuals being young, undereducated women living in the poorest communities. Limited screening and treatment services and challenges to access them lead to delays in diagnosis and treatment, resulting in advanced cancers.
To combat cervical cancer and move forward on the path to its elimination, Timor-Leste has implemented crucial interventions. The country now boasts two facilities for cervical cancer screening and management at the national hospital (HNGV) in Dili and Tirilolo Hospital in Baucau. These centers offer a comprehensive range of services, including Visual Inspection with Acetic Acid (VIA) screening, a colposcopy machine, and the capability to perform thermal ablation procedures for early-stage cancers and precancerous lesions.
The World Health Organization (WHO) has collaborated closely with the Ministry of Health to establish the centres, train healthcare providers and scale up services. By strengthening and expanding cervical cancer screening programs, more women can be identified at an early, treatable stage. Ensuring screening of all women with high performance test by 35 years and again by 45 years of age will be a crucial step in early detection of pre-cancerous lesions and their management.
In addition, the country is also in the process of introducing HPV testing through the process of self-sampling that will allow women to collect their samples in the comfort of their homes or designated safe spaces.
Almost all cases of cervical cancer are caused by the Human Papilloma Virus (HPV), and the HPV vaccine can play a key role in prevention. Timor-Leste plans to roll out the HPV vaccine within this year. Aligning with the WHO’s global strategy for cervical cancer elimination, Timor-Leste must work to achieve 90% HPV vaccination coverage, 70% screening coverage, and 90% access to treatment by 2030.
As the next step, integrating screening and treatment services within primary care package, expanding the health workforce capacity, and organizing population-based prevention and screening platforms will be key steps for further strengthening cervical cancer elimination initiatives in the country. This will ensure that all women, regardless of their geographic location, have access to quality healthcare services, including screening, diagnosis, and treatment.
Eliminating cervical cancer in Timor-Leste is an achievable goal, but it requires a collaborative effort from the government, healthcare professionals, communities, and international partners. By raising awareness, improving screening programs, implementing vaccination initiatives, investing in healthcare infrastructure, and promoting community engagement, we can pace towards a future where cervical cancer no longer threatens the women of Timor-Leste. Let’s act collectively to ensure no woman has to face the burden of this preventable disease.
TATOLI