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Public Health postgraduate earns sole distinction for cervical cancer research

- Wits Univerity

A Master's graduate has produced research that impacts health policy in the field of cervical cancer, which is one of the top five cancers that kill women.

Dr Gbenga Olorunfemi received a Certificate of Commendation at the Faculty of Health Sciences prizegiving on 4 April 2018 to acknowledge his significant research into cervical cancer, which is amongst the leading cancers that kill South African women along with breast cancer. 

A Master’s graduate in the Division of Epidemiology and Biostatistics in the School of Public Health, Olorunfemi’s dissertation, Trends and determinants of the incidence and mortality of cervical cancer in South Africa 1994 – 2012 earned him a distinction at his graduation in July 2017. He was the only student in his cohort to graduate with a first-class pass from the School of Public Health.

Olorunfemi said that although cervical cancer is 100% preventable, it is the leading cause of cancer deaths in sub-Saharan Africa. It was therefore unacceptable that a minimum average of 5 000 South African women was afflicted with cervical cancer annually while the annual death toll was about 3 000 women – as his study revealed.

The study further showed a complex interplay of factors that influence the observed trends of cervical cancer in South Africa. Gbenga believes that the prevalence of HPV [Human papillomavirus] and HIV, smoking rates, socio-economic status, screening rates, sexual and reproductive behaviours, including prolonged hormonal contraceptive use beyond 10 years, and many others all collide to produce the current state of cervical cancer in South Africa.

“We found that in contrast to previous years where there was a major increase in annual cervical cancer incidence, there was a slight increase of cervical cancer incidence from 2001 to 2009, which coincided with the initiation of the free national cervical cancer screening programme in 2000. We also found that there was a drop in cervical cancer mortality from 2004 when the nationwide anti-retroviral therapy (ART) commenced in the country,” says Olorunfemi.

“However, since the ART rollout in the country led to increased longevity among HIV positive women, we further found that there was an increased risk of cervical cancer … among Black HIV positive women. Thus, the ART rollout may paradoxically cause an increase in the risk of cervical cancer among older HIV women.”

The risk factor arm of the study also showed that smokeless tobacco (snuff use) may be associated with the evolution of cervical cancer – a finding that is likely the first at population-level in sub-Saharan Africa on the risk of snuff use and cervical cancer.

“Hence, tobacco control initiatives should include control of smokeless tobacco,” says Olorunfemi.

Olorunfemi added that although the study was at the population level with some recognised limitations, he believes the findings were still able to provide useful information to aid appropriate multi-sectoral interventions on cervical cancer in South Africa.

Olorunfemi has submitted the first paper from his research to aims to the International Journal of Cancer (impact factor: 6.5) where the manuscript is currently undergoing revisions towards possible publication. He aims to publish at least three peer-reviewed journal articles and policy documents from his Master’s. His research is gaining traction and he has already presented six oral and three poster papers at national and international conferences.

He has been accepted for doctoral studies in the Wits School of Public Health where he will research novel contemporary solutions to preventing cervical cancer in Nigeria and South Africa.